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Blepharospasm is a form of adult onset focal dystonia which is associated with progressive involuntary spasms of the eyelid protractors including orbicularis oculi, corrugator, and procerus muscles. The onset is usually in the fifth to seventh decade of life with a female preponderance. Clinical presentations include increased blink rate associated with photophobia and subjective feelings of ocular irritation, more forceful exaggerated blinking, and delayed eyelid opening severe enough to cause functional blindness known as “lid opening apraxia” (see Chap. 17). The spasms may increase with bright light, reading, or watching television and may improve while distracted with other physical tasks such as talking, humming, relaxation, or gazing downward.
KeywordsMultiple System Atrophy Bright Light Progressive Supranuclear Palsy Botulinum Toxin Injection Female Preponderance
Essential blepharospasm.mp4 (MP4 4,792KB)
The patient displays increased blink rate due to intermittent contractions of the orbicularis oculi muscles. There are also sustained contractions of the frontalis, nasalis, and corrugator muscles.