Blepharospasms and Hemifacial Spasms

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Blepharospasms and Hemifacial Spasms

Blepharospasm and hemifacial spasm are neurologic disorders in which the eyelid and facial muscles contract and squeeze involuntarily.  For some patients, this is not only embarrassing, but also severe enough to keep them from being able to open their eyes therefore making them functionally blind. The treatment for these issues is typically Botox® or Xeomin® injections, designed to relax the muscles that are behaving abnormally.

How Diagnosis Is Achieved

Involuntary spasms of the eyelid and/or facial muscles is a frustrating condition, but rarely is it indicative of any more serious underlying problem.  Stated another way, patients whose eyelids or facial muscles twitch and squeeze uncontrollably should not be concerned about health or life-threatening conditions such as tumors, serious infections or neurologic diseases such as multiple sclerosis.  To confirm that there are no serious underlying conditions present, a neurologic evaluation is recommended whenever someone develops uncontrolled facial spasms.

Rarely patients with hemifacial spasm are found to have symptoms caused by a blood vessel and nerve rubbing against one another at the base of the brain.  While it is possible to correct this condition surgically, most patients choose not to undergo such an invasive procedure.

Blepharospasms vs. Hemifacial Spasms

Blepharospam and hemifacial spasm are separate and unrelated disorders.  One does not change or evolve into the other. Blepharospasm is the term used to describe uncontrolled closing of both eyes; it usually does not affect the lower facial muscles. A hemifacial spasm, on the other hand, is a condition in which uncontrollable squeezing of facial muscles affects muscles in both the upper and lower parts of only one side of the face.  Typically, the eyelids are involved in the upper face, and the muscles around the mouth and upper neck are affected in the lower face.

Using Botox or Xeomin for Treatment

There are no traditional medical treatments for blepharospasm or hemifacial spasm.  The mainstay of treatment for blepharospasm and hemifacial spasm is injection of medications Botox or Xeomin, that relaxes the muscles, keeping them from squeezing.  Botox and Xeomin are administered with a tiny needle directly into the muscles that are behaving abnormally.  The effects of Botox and Xeomin are usually apparent within three to five days, with up to two weeks required to achieve maximum results.    Botox and Xeomin typically are effective in relieving spasms for three months in patients with blepharospasm and up to six months in patients with hemifacial spasm.  Botox and Xeomin do not cure these conditions; once the effects wear off the injections will need to repeated.  Fortunately Botox and Xeomin are safe drugs, even with long-term use, as most patients continue treatment for the remainder of their lifetime.