Essential Blepharospasm

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


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.


Multiple System Atrophy Bright Light Progressive Supranuclear Palsy Botulinum Toxin Injection Female Preponderance 
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Supplementary material

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.


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    Grandas F, Elston J, Quinn N, et al. Blepharospasm: a review of 264 patients. J Neurol Neurosurg Psychiatry. 1988;51:767–72.PubMedCentralPubMedCrossRefGoogle Scholar
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    Defazio G, Abbruzzese G, Aniello MS, et al. Environmental risk factors and clinical phenotype in familial and sporadic primary blepharospasm. Neurology. 2011;77:631–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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