Benign Essential Blepharospasm (BEB)
- Article
- 2021-03-05
Benign essential blepharospasm (BEB) is a progressive neurological disorder characterized by involuntary muscle contractions and spasm of the eyelid muscles. It is a form of dystonia, a movement disorder in which muscle contractions lead to persistent eyelid closure, twitching or repetitive movements. BEB begins gradually with an increased frequency of eye blinking, often associated with eye irritation. Other symptoms may include increasing difficulty in keeping the eyes open and sensitivity to light. Generally, the spasms occur during the day, disappear in sleep, and reappear after waking up. As the condition progresses, the spasms can get worse, forcing the eyelids to remain closed for long periods of time, causing significant visual disturbances or functional blindness. It is important to note that the blindness is caused solely by uncontrollable closing of the eyelids and not by eye dysfunction. BEB occurs in both men and women, although it is especially common in middle-aged and older women.
Therapy
In most cases of BEB, the treatment of choice is botulinum toxin injections that relax the muscles and stop the spasms. Other treatment options include medications (drug therapy) or surgery - either local surgery of the eye muscles or deep brain stimulation surgery.
Prognosis
With botulinum toxin treatment, most people with BEB have significant symptom relief. While some may experience side effects such as drooping eyelids, blurred or double vision, and dry eyes, these side effects are usually only temporary. The condition can worsen or spread to the surrounding muscles; stay the same for years; and, in rare cases, improve spontaneously.
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