ARE THERE ORAL techniques may be beneficial. Dark glasses are MEDICATIONS FOR also recommended because they reduce the BLEPHAROSPASM AND BLEPHAROSPASM? intensity of sunlight and help with discomfort Drug therapies for blepharospasm and in social settings. Education is vital when MEIGE’S SYNDROME Meige’s syndrome can be trial and error. dealing with a dystonia diagnosis and Medications have different mechanisms of reassurance from family, friends and others is action and generally produce unpredictable beneficial. Patients with blepharospasm may and short-lasting benefits. Establishing a fear sustained spasms occurring while driving, satisfactory treatment plan requires patience socializing or taking part in an activity and if Tyler’s Hope on the part of the patient and the this fear becomes overwhelming, the patient is neurologist. at risk for becoming socially isolated. Support Center for Comprehensive groups can be beneficial by offering Medications typically used to treat encouragement and camaraderie. Dystonia Care blepharospasm include: Artane (trihexyphenidyl) Ativan (lorazepam) Cogentin (benztropine) MY DOCTOR IS NOT A partnership between Klonapin (clonazpam) FAMILIAR WITH THIS Lioresal (baclofen) CONDITION. WHAT Valium (diazepam) SHOULD I DO? Give your doctor a copy of this brochure as an introduction. Blepharospasm and Meige’s IS SURGERY AN syndrome are rare disorders. Make sure your ALTERNATIVE FOR primary care provider (PCP) has a good BLEPHAROSPASM? relationship with your neurologist and/or ophthalmologist. This will ensure that they A myectomy (surgical removal of the muscles collaborate for your benefit. that control the eyelid and brow-squeezing) is available to treat blepharospasm. Candidates for myectomy are usually those for whom WHAT SHOULD I DO NOW botulinum toxin treatment is not effective. It THAT I HAVE BEEN is important to note that not every eye DIAGNOSED? specialist can perform a myectomy. In selected Provided by cases, deep brain stimulation (DBS) surgery Knowledge is power. Work closely with your Tyler’s Hope Center for has been successfully performed for certain doctor to find a treatment plan that works for Comprehensive Dystonia Care types of dystonia. For more information visit you. There are many treatment options to help University of Florida Movement Disorders Center http://mdc.ufl.edu. alleviate symptoms. Be sure to alert your PO BOX 100236, Gainesville, Fl, 32610 doctor if your treatment plan has undesirable 352-273-6885 WHAT ELSE CAN BE DONE side effects or if you have questions or mdc.mbi.ufl.edu TO HELP WITH THE concerns. Remember to persevere, and keep a www.tylershope.org SYMPTOMS? positive attitude.

Stress can increase the symptoms of dystonia. Using stress management and relaxation WHAT IS DYSTONIA? HOW IS BLEPHAROSPASM WHAT IS MEIGE’S Dystonia is a neurologic syndrome DIAGNOSED? SYNDROME? characterized by involuntary muscle Patients with blepharospasm have normal Meige’s syndrome is also called cranio-facial contractions of opposing muscles that may eyesight. To diagnose blepharospasm, your dystonia. Typical symptoms include result in twisting and repetitive movements doctor must first rule out: involuntary blinking, chin thrusting, tongue or abnormal postures. When dystonia  Ptosis – drooping of the eyelids protrusion, squinting, light sensitivity and affects a single body area, it is called “focal” caused by weakness or paralysis of muddled speech. Treatments for Meige’s dystonia. Blepharospasm is a focal dystonia the upper eyelid muscle syndrome, such as botulinum injections, are affecting the eyes.  Blepharitis – an inflammatory the same as those for blepharospasm and other condition of the eyelids due to forms of facial dystonia. infection or allergies WHAT IS BLEPHAROSPASM ?  Hemifacial spasm – a condition that Blepharospasm (blef-a-ro-spaz-em) is a may look like blepharospasm but WHAT ARE BOTULINUM condition in which there is sustained, only involves one side of the face. TOXIN INJECTIONS? forced, involuntary closing of the eyelids. Patients experience twitching of the Botulinum toxin injections are one of the Blepharospasm is a form of dystonia that eyelid, face and mouth on the most effective treatments for affects the head and face and often, is affected side unlike blepharospasm blepharospasm and Meige’s syndrome. referred to as “cranial” dystonia. which involves both eyes but often Botulinum toxin, a biological product, is spares the face and mouth. injected into specific muscles above and below the eyes or other parts of the face, WHAT CAUSES where it acts to relax the muscles and reduce BLEPHAROSPASM? excessive muscle contractions. Benefits HOW DOES begin one to fourteen days following The cause of blepharospasm is thought to BLEPHAROSPASM BEGIN? injection and last for an average of three to be due to abnormal functioning of the four months. Long-term studies have “basal ganglia” (a small area situated in the Blepharospasm usually begins gradually with shown it to be a safe and effective treatment middle of the brain). The basal ganglia play excessive blinking and/or eye irritation. In with approximately 80 percent of patients a role in coordinating movements. the early stages it may only occur with obtaining almost complete relief of their Sometimes a history of eye trauma may stressors such as bright lights, fatigue or blepharospasm. trigger (precipitate) blepharospasm, however emotional tension. As the condition in most cases it develops spontaneously progresses, it may occur more frequently Side effects are infrequent and usually with no known cause. In some cases, it may throughout the day. The severity of the temporary. They include drooping of the be an inherited disorder with more than one spasms may lessen or vanish during sleep eyelid, blurred vision, facial asymmetry and family member affected. Blepharospasm and may subside following rest. double vision. Constant tears may occur. can be seen in other neurologic conditions Concentration on a specific task may also All symptoms fully recover spontaneously. like Parkinson’s disease and also can be a reduce the frequency of the spasms. Treatments are typically scheduled over side effect of certain medications such as three to four month intervals to maintain those used to treat psychiatric conditions Some patients may experience spasms so effectiveness. like schizophrenia and bi-polar disorder. intense that the eyelids may remain forcefully closed for several hours at a time.