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Blepharospasm

What is Blepharospasm?

Blepharospasm is a neurological condition that causes involuntary closing, twitching, or blinking of the eyelids. It can affect one or both eyes and interfere with vision and daily activities.

Blepharospasm is a type of focal dystonia, which means abnormal muscle contractions in one part of the body. It is estimated to affect about 16 to 133 people per million. Women and older adults are more commonly affected.

Botulinum toxin injections are approved by the Therapeutic Goods Administration (TGA) for treating blepharospasm in patients who have had an inadequate response to other treatments. The injections need to be repeated every few months to maintain the effect.

What are The Symptoms of Blepharospasm?

Mild twitching of the eyelids is typically called tics or twitches. In blepharospasm, the abnormal twitching or closing of the eyelids is much more severe, causing discomfort, visual impairment, and social embarrassment.

Some of the symptoms of blepharospasm are:

  • Frequent, uncontrolled blinking
  • Forced closing of the eyes or difficulty opening them
  • Sensitivity to light
  • Dry or irritated eyes
  • Blurry vision

The symptoms may vary in severity and frequency, and they may get worse over time. They may also be triggered by stress, fatigue, anxiety, bright lights, wind, or air pollution.

DBS is used to treat various neurological and psychiatric conditions, including:

  • Essential tremor: one of the most common types of adult-onset movement disorder that is characterized by trembling or shaking of the hands but can also affect the head, trunks, voice, and legs.
  • Parkinson’s disease: a progressive neurological disorder affecting movement, balance, and coordination.
  • Dystonia: a movement disorder characterized by muscle contractions that cause abnormal postures and movements.
  • Tourette syndrome: a neurodevelopmental disorder characterised by repetitive, involuntary movements and vocalizations called tics. Symptoms can involve a wide range of movements, such as eye blinking, facial grimacing, shoulder shrugging, and jerking.
  • Epilepsy: a neurological disorder that causes recurrent, unprovoked seizures due to abnormal electrical activity in the brain.
  • Obsessive-compulsive disorder: an anxiety disorder in which people have intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels compelled to perform.

Although not without risks, DBS is safe and highly effective in properly selected patients. It is typically recommended for individuals whose neurological conditions have not responded well to medications or who cannot tolerate high doses due to side effects.

  • Reduction of Symptoms

Treatment with DBS results in improved functioning and a reduced need for medications in some cases.

  • Non-Invasive

Unlike ablative surgery, DBS does not remove or destroy brain tissue. This can lead to a faster recovery time and reduced risk of complications.

  • Customizable

Although DBS works by providing continuous stimulation, it can also be adjusted through remote control, allowing patients to turn it on and off as needed.

  • Long-lasting Results

DBS has been shown to produce long-lasting results in reducing the symptoms of various disorders. A recent study revealed that DBS remains effective after 15 years in patients with Parkinson’s disease.

  • Reversible

If a patient experiences adverse effects, the DBS program can be adjusted to avoid them. If the treatment is no longer needed, the electrodes and pulse generator can be removed without causing permanent damage.

Like any surgical procedure, there are potential risks associated with deep brain stimulation. However, most are mild and temporary. More serious complications, such as infection or stroke, may occur in rare cases. These can be prevented by proper pre-procedure screening and careful monitoring during the recovery period.

Risks and side effects of DBS placement

  • Dizziness
  • Headaches
  • Worsening neurological condition
  • Problems in concentrating
  • Loss of balance
  • Speech or vision problems
  • Infection
  • Pain or swelling
  • Bleeding in the brain

Additionally, patients should monitor battery life closely since IPGs traditionally require replacement every three years due to their limited capacity.

What to Expect After Treatment?

Botulinum toxin injections can reduce the frequency and severity of eyelid spasms in most people with blepharospasm.

Patients can expect to see improvements in their symptoms within 2-4 days post-injection, with peak effects usually occurring after a week. The results typically last up to 4 months, after which the injection may need to be repeated.

Botulinum toxin injections are generally well-tolerated and have few side effects. These can include dry eyes, drooping eyelids, blurred vision, and increased sensitivity to light. However, these side effects are usually temporary and resolve on their own.

Book an appointment

At Melbourne NeuroCare, we have a team of experts who can provide you with botulinum toxin injections and other advanced treatments for various movement disorders. To book an appointment or learn more about our clinic, please call us at 1300 080 784. We look forward to hearing from you soon!