Skip to main content
SpringerLink
Log in

Analysis of blink activity and anomalous eyelid movements in patients with hemifacial spasm

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

To assess spontaneous blinking and anomalous eyelid movements in patients with hemifacial spasm with an emphasis on interocular differences. Spontaneous eyelid movements were registered bilaterally for 3 min using a high-speed video camera in 28 patients with hemifacial spasm (HFS) who had not been treated with botulinum toxin injections for at least 5 months. The degree of blink conjugacy, maximum velocity, and amplitude of the closing phase of the blinks were determined for the affected and non-affected sides. Out of the 28 subjects, 23 (82%) presented with abnormal nonconjugate spasms that were similar to blinks, and in 17 (61%), high-frequency eyelid twitches were detected between blinks on the affected eye. The rate of nonconjugate blink-like spasms ranged from 0.3 to 24.7 movements/min. With regard for conjugate blinks, there was no significant interocular difference in amplitudes or eyelid closure velocities. The amplitude and velocity were significantly lower for nonconjugate movements than for spontaneous blinks. HFS is a unique condition in which complex patterns of eyelid movements, including both conjugate and nonconjugate movements, are present. Conjugate movements correspond to spontaneous blinking, and the same metrics were observed in affected and non-affected eyes. Nonconjugate movements correspond to anomalous nonconjugate blink-like spasms and high-frequency eyelid twitches in the affected eye, both of which were characterized by lower amplitudes and velocities than were observed in conjugate movements.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Wang A, Jankovic J (1998) Hemifacial spasm: clinical findings and treatment. Muscle Nerve 21:1740–1747

    Article  CAS  Google Scholar 

  2. Chaudhry N, Srivastava A, Joshi L (2015) Hemifacial spasm: the past, present and future. J Neurol Sci 356(1–2):27–313

    Article  Google Scholar 

  3. Abbruzzese G, Berardelli A, Defazio G (2011) Hemifacial spasm. Hyperkinetic Mov Disord 100:675–680

    Article  Google Scholar 

  4. Ross AH, Elston JS, Marion MH, Malhotra R (2011) Review and update of involuntary facial movement disorders presenting in the ophthalmological setting. Surv Ophthalmol 56:54–67

    Article  Google Scholar 

  5. Stava MW, Huffman MD, Baker RS, Epstein AD, Porter JD (1994) Conjugacy of spontaneous blinks in man: eyelid kinematics exhibit bilateral symmetry. Invest Ophthalmol Vis Sci 35:3966–3971

    CAS  PubMed  Google Scholar 

  6. Huffman MD, Baker RS, Stava MW, Chuke JC, Rouholiman BR, Porter JD (1996) Kinematic analysis of eyelid movements in patients recovering from unilateral facial nerve palsy. Neurology 46:1079–1085

    Article  CAS  Google Scholar 

  7. Cruz AA, Garcia DM, Pinto CT, Cechetti SP (2011) Spontaneous eyeblink activity. Ocul Surf 9(1):29–41

    Article  Google Scholar 

  8. Evinger C, Ka M, Pa S (1991) Eyelid movements. Mechanisms and normal data. Invest Ophthalmol Vis Sci 32:387–400

    CAS  PubMed  Google Scholar 

  9. Palakuru J, Wang J, Aquavella JV (2007) Effects of blinking on tear dynamics. Invest Ophthalmol Vis Sci 48:3032–3037

    Article  Google Scholar 

  10. Garcia D, Barbosa JC, Pinto CT, Cruz AA (2013) Estimation of spontaneous blinking main sequence in normal subjects and patients with graves’ upper eyelid retraction. Invest Ophthalmol Vis Sci 54:1434–1442

    Article  Google Scholar 

  11. Wambier SP, Garcia DM, Cruz AA, Messias A (2016) Spontaneous blinking kinetics on paralytic Lagophthalmos after lid load with gold weight or autogenous temporalis fascia sling. Curr Eye Res 41(4):433–440

    PubMed  Google Scholar 

  12. Baccega A, Garcia DM, Cruz AAV (2017) Spontaneous blinking kinematics in patients who have undergone Autogeneous fascia Frontalis suspension. Curr Eye Res 42(9):1248–1253

    Article  Google Scholar 

  13. Kimura N, Watanabe A, Suzuki K, Toyoda H, Hakamata N, Fukuoka H, Washimi Y, Arahata Y, Takeda A, Kondo M, Mizuno T, Kinoshita S (2017) Measurement of spontaneous blinks in patients with Parkinson's disease using a new high-speed blink analysis system. J Neurol Sci 380:200–204

    Article  Google Scholar 

  14. Jankovic J, Kenney C, Grafe S, Goertelmeyer R, Comes G (2009) Relationship between various clinical outcome assessments in patients with blepharospasm. Mov Disord 24:407–413

    Article  Google Scholar 

  15. Wambier S, Ribeiro SF, Garcia DM et al (2014) Two-dimensional video analysis of the upper eyelid motion during spontaneous blinking. Ophthal Plast Reconstr Surg 30:146–151

    Article  Google Scholar 

  16. Manning KA, Evinger C, Sibony PA (1990) Eyelid movements before and after Botulinum therapy in patients with lid spasm. Ann Neurol 28:653–660

    Article  CAS  Google Scholar 

  17. Porter JD, Burns LA, May PJ (1989) Morphological substrate for eyelid movements: innervation and structure of primate levator palpebrae superioris and orbicularis oculi muscles. J Comp Neurol 287:64–81

    Article  CAS  Google Scholar 

  18. Osaki MH, Osaki TH, Osaki T, Gameiro GR, Belfort R Jr, Marie SKN (2019) Orbicularis oculi morphological alterations in affected and non-affected sides in hemifacial spasm. J Neuro-ophthalmol. https://doi.org/10.1097/WNO.0000000000000823

  19. Hasan SA, Baker RS, Sun WS, Rouholiman BR, Chuke JC, Cowen DE, Porter JD (1997) The role of blink adaptation in the pathophysiology of benign essential blepharospasm. Arch Ophthalmol 115(5):631–6.27

    Article  CAS  Google Scholar 

  20. Aramideh M, Ongerboer de Vissser BW, Devriese PP et al (1994) Electromyographic features of levator palpebrae superioris and orbicularis oculi muscles in blepharospasm. Brain 117:27–38

    Article  Google Scholar 

  21. Bentivoglio AR, Daniele A, Albanese A, Tonali PA, Fasano A (2006) Analysis of blink rate in patients with blepharospasm. Mov Disord 21(8):1225–1229

    Article  Google Scholar 

  22. Ferrazzano G, Conte A, Belvisi D, Fabbrini A, Baione V, Berardelli A, Fabbrini G (2019) Writing, reading, and speaking in blepharospasm. J Neurol 266(5):1136–1140

    Article  Google Scholar 

  23. Lee WH, Seo JM, Hwang JM (2017) The analysis of eye blinking pattern using high-frame-rate camera. Conf Proc IEEE Eng Med Biol Soc 2017:1509–1512

    Google Scholar 

  24. Doane MG (1980) Interactions of eyelids and tears in corneal wetting and the dynamics of the normal human eyeblink. Am J Ophthalmol 89:507–516

    Article  CAS  Google Scholar 

  25. Kwon K-A, Shipley RJ, Edirisinghe M, Ezra DG, Rose G, Best SM, Cameron RE (2013) High-speed camera characterization of voluntary eye blinking kinematics. J R Soc Interface 10(85):213–227

    Article  Google Scholar 

  26. Malbouisson J, Messias A, Garcia DM et al (2010) Modeling upper eyelid kinematics during spontaneous and reflex blinks. J Neurosci Methods 191:119–125

    Article  Google Scholar 

  27. Sforza C, Rango M, Galante D et al (2008) Spontaneous blinking in healthy persons: an optoelectronic study of eyelid motion. Ophthalmic Physiol Opt 28:345–353

    Article  Google Scholar 

  28. Frigerio A, Hadlock TA, Murray EH, Heaton JT (2014) Infrared-based blink-detecting glasses for facial pacing: toward a bionic blink. JAMA Facial Plast Surg 16:211–218

    Article  Google Scholar 

  29. Hanuka A, Itzhak M, Berger A et al (2017) A novel eyelid motion monitor. Graefes Arch Clin Exp Ophthalmol 255:1811–1817

    Article  Google Scholar 

  30. Hershman R, Henik A, Cohen N (2018) A novel blink detection method based on pupillometry noise. Behav Res Methods 50:107–114

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - EPM/ UNIFESP, São Paulo, SP, Brazil

    Midori H. Osaki, Tammy H. Osaki, Teissy Osaki & Rubens Belfort Jr

  2. Osaki Ophthalmology Clinics, São Paulo, SP, Brazil

    Midori H. Osaki, Tammy H. Osaki & Teissy Osaki

  3. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo/Ribeirão Preto, Ribeirão Preto, São Paulo, SP, Brazil

    Denny M. Garcia & Antonio Augusto V. Cruz

  4. University of São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil

    Gustavo R. Gameiro

Authors
  1. Midori H. Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tammy H. Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Denny M. Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Teissy Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gustavo R. Gameiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rubens Belfort Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Antonio Augusto V. Cruz
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Midori H. Osaki: (1) research project: (a) conception, (b) organization, (c) execution; (2) statistical analysis: (a) design, (b) review, (c) and critique; (3) manuscript preparation: (a) writing of the first draft and (b) review and approval of the final version.

Tammy H. Osaki: (1) research project: (a) conception, (b) organization, (c) execution; (2) statistical analysis: (a) review and critique; (3) manuscript preparation: (a) review and critique and (b) approval of the final version.

Denny Garcia: (1) research project: (a) execution; (2) statistical analysis: (a) design and (b) execution; (3) manuscript preparation: (a) review and critique and (b)approval of the final version.

Teissy Osaki: (1) research project: (a) organization and (b) execution; (2) statistical analysis: (a) review and critique; (3) manuscript preparation: (a) review and critique and (b) approval of the final version.

Gustavo Gameiro: (1) research project: (a) execution; (2) statistical analysis: (a) review and critique; (3) manuscript preparation: (a) review and critique and (b) approval of the final version.

Rubens Belfort Jr.: (1) research project: (a) conception; (2) statistical analysis: (a) review and critique; (3) manuscript preparation: (a) review and critique and (b) approval of the final version.

Antonio Augusto Cruz: (1) research project: (a) conception, (b) organization; (2) statistical analysis: (a) review and critique; (3) manuscript preparation: (a) review and critique and (b) approval of the final version.

Corresponding author

Correspondence to Midori H. Osaki.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the UNIFESP IRB (number 1322/2016) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Osaki, M.H., Osaki, T.H., Garcia, D. et al. Analysis of blink activity and anomalous eyelid movements in patients with hemifacial spasm. Graefes Arch Clin Exp Ophthalmol 258, 669–674 (2020). https://doi.org/10.1007/s00417-019-04567-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-019-04567-w

Keywords

Search

Navigation