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Essential Blepharospasm and Hemifacial Spasm

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Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

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Abstract

Benign essential blepharospasm (henceforth “blepharospasm”) and hemifacial spasm are conditions which are linked in the final manifestation of facial spasm and are similar in regard to basic approaches to treatment. Both these diseases are movement disorders but have completely different pathophysiology. For this reason, this chapter is divided into two sections, the first on blepharospasm and the second on hemifacial spasm.

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References

  1. Talkow J. Klonische krampfe der angelinder: neurotomie der supraorbitalnerven. Klin Montasbl Augenheilkd. 1870;8:129–45.

    Google Scholar 

  2. Meige H. Les convulsion de la face une form clinique de convulsion faciale, bilateral et mediane. Rev Neurol (Paris). 1907;10:437–43.

    Google Scholar 

  3. Jankovic JJ. Etiology and differential diagnosis of blepharospasm and oromandibular dystonia. Adv Neurol. 1988;49:103–16.

    CAS  PubMed  Google Scholar 

  4. Reynolds DH, Smith JL, Walsh TJ. Differential section of the facial nerve for blepharospasm. Trans Am Acad Ophthalmol Otolaryngol. 1967;71:656–64.

    CAS  PubMed  Google Scholar 

  5. Callahan A. Surgical correction of intractable blepharospasm: technical improvements. Am J Ophthalmol. 1965;60:788–91.

    Article  CAS  PubMed  Google Scholar 

  6. Weingarten CZ, Putterman AM. Management of patients with essential blepharospasm. Eye Ear Nose Throat Mon. 1976;55:8–24.

    CAS  PubMed  Google Scholar 

  7. Henderson JW. Essential blepharospasm. Trans Am Ophthalmol Soc. 1956;54:453–520.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Goldstein JE, Cogan DG. Apraxia of lid opening. Arch Ophthalmol. 1965;73:155–9.

    Article  CAS  PubMed  Google Scholar 

  9. Lepore FE, Devoisin RC. ‘Apraxia’ of eyelid opening: an involuntary levator inhibition. Neurology. 1985;35:423–7.

    Article  CAS  PubMed  Google Scholar 

  10. Jordan DR, Anderson RL, Digre KB. Apraxia of lid opening in blepharospasm. Ophthalmic Surg. 1990;21:331–4.

    CAS  PubMed  Google Scholar 

  11. Georgescu D, Vagefi MR, McMullan TF, McCann JD, Anderson RL. Upper eyelid myectomy in blepharospasm with associated apraxia of lid opening. Am J Ophthalmol. 2008;145(3):541–7.

    Article  PubMed  Google Scholar 

  12. Anderson RL, Patel BC, Holds JB, Jordan DR. Blepharospasm: past, present, and future. Ophthal Plast Reconstr Surg. 1998;14:305–17.

    Article  CAS  PubMed  Google Scholar 

  13. Peckham EL, Lopez G, Shamim EA, et al. Clinical features of patients with blepharospasm: a report of 240 patients. Eur J Neurol. 2011;18(3):382–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Jankovic JJ, Patel SC. Blepharospasm associated with brainstem lesions. Neurology. 1983;33:1237–40.

    Article  CAS  PubMed  Google Scholar 

  15. Aramideh M, Bour LJ, Koelman JH, et al. Abnormal eye movements in blepharospasm and involuntary levator palpebrae inhibition. Brain. 1994;117:1457–74.

    Article  PubMed  Google Scholar 

  16. Hotson JR, Boman DR. Memory-contingent saccades and the substantia nigra postulate for essential blepharospasm. Brain. 1991;114:295–307.

    PubMed  Google Scholar 

  17. Jankovic JJ. Clinical features, differential diagnosis and pathogenesis of blepharospasm and cranial-cervical dystonia. In: Bosniak SL, Smith BC, editors. Advances in ophthalmic plastic and reconstructive surgery, vol. 4. New York: Pergamon Press; 1985. p. 67–82.

    Google Scholar 

  18. Creel DJ, Holds JB, Anderson RL. Auditory brain-stem responses in blepharospasm. Electroencephalogr Clin Neurophysiol. 1993;86:138–40.

    Article  CAS  PubMed  Google Scholar 

  19. Eftekhari K, Choe CH, Vagefi MR, et al. Oral methylphenidate for the treatment of refractory facial dystonias. Ophthalmic Plast Reconstr Surg. 2015;31(3):e65–6.

    Article  PubMed  Google Scholar 

  20. Price KM, Ramey NA, Richard MJ, et al. Can methylphenidate objectively provide relief in patients with uncontrolled blepharospasm? A pilot study using surface electromyography. Ophthalmic Plast Reconstr Surg. 2010;26(5):353–6.

    Article  PubMed  Google Scholar 

  21. Vijayakumar D, Wijemanne S, Jankovic J. Treatment of blepharospasm with apraclonidine. J Neurol Sci. 2017;372:57–9.

    Article  CAS  PubMed  Google Scholar 

  22. Alderson K, Holds JB, Anderson RL. Botulinum-induced alterations of nerve-muscle interactions in the human orbicularis oculi following treatment for blepharospasm. Neurology. 1991;41:1800–5.

    Article  CAS  PubMed  Google Scholar 

  23. Scott AB. Botulinum toxin injection of eye muscles to correct strabismus. Trans Am Ophthalmol Soc. 1981;79:734–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Kennedy RA, Stubbs HA. Botulinum-A toxin injection as a treatment for blepharospasm. Arch Ophthalmol. 1985;103:347–50.

    Article  PubMed  Google Scholar 

  25. Kollewe K, Mohammadi B, Kohler S, et al. Blepharospasm: long-term treatment with either Botox(R), Xeomin(R) or Dysport(R). J Neural Transm (Vienna). 2015;122(3):427–31.

    Article  CAS  Google Scholar 

  26. Chundury RV, Couch SM, Holds JB. Comparison of preferences between onabotulinumtoxinA (Botox) and incobotulinumtoxinA (Xeomin) in the treatment of benign essential blepharospasm. Ophthalmic Plast Reconstr Surg. 2013;29(3):205–7.

    Article  PubMed  Google Scholar 

  27. Albrecht P, Jansen A, Lee JI, et al. High prevalence of neutralizing antibodies after long-term botulinum neurotoxin therapy. Neurology. 2019;92(1):e48–54.

    Article  CAS  PubMed  Google Scholar 

  28. Adler CH, Factor SA, Brin M, Sethi KD. Secondary nonresponsiveness to botulinum toxin type A in patients with oromandibular dystonia. Mov Disord. 2002;17(1):158–61.

    Article  PubMed  Google Scholar 

  29. Koshy JC, Sharabi SE, Feldman EM, et al. Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol. 2012;11(4):507–12.

    CAS  PubMed  Google Scholar 

  30. Cohen JL. Scientific skepticism and new discoveries: an analysis of a report of zinc/phytase supplementation and the efficacy of botulinum toxins in treating cosmetic facial rhytides, hemifacial spasm and benign essential blepharospasm. J Cosmet Laser Ther. 2014;16(5):258–62.

    Article  PubMed  Google Scholar 

  31. Esposito M, Fasano A, Crisci C, et al. The combined treatment with orbital and pretarsal botulinum toxin injections in the management of poorly responsive blepharospasm. Neurol Sci. 2014;35(3):397–400.

    Article  PubMed  Google Scholar 

  32. Huang L, Costin BR, Sakolsatayadorn N, Perry JD. Safety of onabotulinum toxin a injection to the central upper eyelid and eyebrow regions. Ophthalmic Plast Reconstr Surg. 2014;30(5):377–80.

    Article  CAS  PubMed  Google Scholar 

  33. Dutton JJ, White JJ, Richard MJ. Myobloc for the treatment of benign essential blepharospasm in patients refractory to botox. Ophthalmic Plast Reconstr Surg. 2006;22(3):173–7.

    Article  PubMed  Google Scholar 

  34. Gillum WN, Anderson RL. Blepharospasm surgery: anatomic approach. Arch Ophthalmol. 1981;99:1056–62.

    Article  CAS  PubMed  Google Scholar 

  35. Jordan DR, Patrinely JR, Anderson RL, et al. Essential blepharospasm and related dystonias. Surv Ophthalmol. 1989;34:123–32.

    Article  CAS  PubMed  Google Scholar 

  36. McCord CD, Coles WH, Shore JW, et al. Treatment of essential blepharospasm. I. Comparison of facial nerve avulsion and eyebrow-eyelid muscle stripping procedure. Arch Ophthalmol. 1984;102:266–8.

    Article  PubMed  Google Scholar 

  37. Frueh BR, Musch DC, Bersani TA. Effects of eyelid protractor excision for the treatment of benign essential blepharospasm. Am J Ophthalmol. 1992;113:681–6.

    Article  CAS  PubMed  Google Scholar 

  38. Patel BCK, Anderson RL. Blepharospasm and related facial movement disorders. Curr Opin Ophthalmol. 1995;5:86–99.

    Article  Google Scholar 

  39. Kent TL, Petris CK, Holds JB. Effect of upper eyelid myectomy on subsequent chemodenervation in the management of benign essential blepharospasm. Ophthalmic Plast Reconstr Surg. 2015;31(3):222–6.

    Article  PubMed  Google Scholar 

  40. Yen MT, Anderson RL, Small RG. Orbicularis oculi muscle graft augmentation after protractor myectomy in blepharospasm. Ophthal Plast Reconstr Surg. 2003;19:287–96.

    Article  PubMed  Google Scholar 

  41. Adler CH, Zimmerman RA, Savino PJ, et al. Hemifacial spasm: evaluation by magnetic resonance imaging and magnetic resonance tomographic angiography. Ann Neurol. 1992;32(4):502–6.

    Article  CAS  PubMed  Google Scholar 

  42. Digre K, Corbett JJ. Hemifacial spasm: differential diagnosis, mechanism, and treatment. Adv Neurol. 1988;49:151–76.

    CAS  PubMed  Google Scholar 

  43. Girard N, Poncet M, Caces F, et al. Three-dimensional MRI of hemifacial spasm with surgical correlation. Neuroradiology. 1997;39(1):46–51.

    Article  CAS  PubMed  Google Scholar 

  44. Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS. Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients. J Neurosurg. 1977;47(3):321–8.

    Article  CAS  PubMed  Google Scholar 

  45. Nielsen VK. Pathophysiology of hemifacial spasm: I. Ephaptic transmission and ectopic excitation. Neurology. 1984;34(4):418–26.

    Article  CAS  PubMed  Google Scholar 

  46. Nielsen VK. Pathophysiology of hemifacial spasm: II. Lateral spread of the supraorbital nerve reflex. Neurology. 1984;34(4):427–31.

    Article  CAS  PubMed  Google Scholar 

  47. Nielsen VK, Jannetta PJ. Pathophysiology of hemifacial spasm: III. Effects of facial nerve decompression. Neurology. 1984;34(7):891–7.

    Article  CAS  PubMed  Google Scholar 

  48. Tan EK, Jankovic J. Hemifacial spasm and hypertension: how strong is the association? Mov Disord. 2000;15(2):363–5.

    Article  CAS  PubMed  Google Scholar 

  49. Yaltho TC, Jankovic J. The many faces of hemifacial spasm: differential diagnosis of unilateral facial spasms. Mov Disord. 2011;26(9):1582–92.

    Article  PubMed  Google Scholar 

  50. Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. Muscle Nerve. 1998;21(12):1740–7.

    Article  CAS  PubMed  Google Scholar 

  51. Ehni G, Woltman HW. Hemifacial spasm: review of one hundred and six cases. Arch Neurol Psychiatr. 1945;53(3):205–11.

    Article  Google Scholar 

  52. Tan EK, Jankovic J. Bilateral hemifacial spasm: a report of five cases and a literature review. Mov Disord. 1999;14(2):345–9.

    Article  CAS  PubMed  Google Scholar 

  53. Defazio G, Abbruzzese G, Girlanda P, et al. Botulinum toxin A treatment for primary hemifacial spasm: a 10-year multicenter study. Arch Neurol. 2002;59(3):418–20.

    Article  PubMed  Google Scholar 

  54. Czyz CN, Burns JA, Petrie TP, et al. Long-term botulinum toxin treatment of benign essential blepharospasm, hemifacial spasm, and Meige syndrome. Am J Ophthalmol. 2013;156(1):173–7. e2

    Article  CAS  PubMed  Google Scholar 

  55. Schellini SA, Matai O, Igami TZ, Padovani CR, Padovani CP. Essential blepharospasm and hemifacial spasm: characteristic of the patient, botulinum toxin A treatment and literature review. Arq Bras Oftalmol. 2006;69(1):23–6.

    Article  PubMed  Google Scholar 

  56. Calace P, Cortese G, Piscopo R, et al. Treatment of blepharospasm with botulinum neurotoxin type A: long-term results. Eur J Ophthalmol. 2003;13(4):331–6.

    Article  CAS  PubMed  Google Scholar 

  57. Vartanian AJ, Dayan SH. Complications of botulinum toxin a use in facial rejuvenation. Facial Plast Surg Clin North Am. 2005;13(1):1–10.

    Article  PubMed  Google Scholar 

  58. Eckman PB, Kramer RA, Altrocchi PH. Hemifacial spasm. Arch Neurol. 1971;25(1):81–7.

    Article  CAS  PubMed  Google Scholar 

  59. Savino PJ, Sergott RC, Bosley TM, Schatz NJ. Hemifacial spasm treated with botulinum A toxin injection. Arch Ophthalmol. 1985;103(9):1305–6.

    Article  CAS  PubMed  Google Scholar 

  60. Garland PE, Patrinely JR, Anderson RL. Hemifacial spasm. Results of unilateral myectomy. Ophthalmology. 1987;94(3):288–94.

    Article  CAS  PubMed  Google Scholar 

  61. Tan N, Chan L, Tan E. Hemifacial spasm and involuntary facial movements. QJM. 2002;95(8):493–500.

    Article  PubMed  Google Scholar 

  62. Miller LE, Miller VM. Safety and effectiveness of microvascular decompression for treatment of hemifacial spasm: a systematic review. Br J Neurosurg. 2012;26(4):438–44.

    Article  PubMed  Google Scholar 

  63. Sindou M, Fobé JL, Ciriano D, Fischer C. Hearing prognosis and intraoperative guidance of brainstem auditory evoked potential in microvascular decompression. Laryngoscope. 1992;102(6):678–82.

    Article  CAS  PubMed  Google Scholar 

  64. Payner TD, Tew JM. Recurrence of hemifacial spasm after microvascular decompression. Neurosurgery. 1996;38(4):686–90; discussion 690–1

    Article  CAS  PubMed  Google Scholar 

  65. Han I, Chang JH, Chang JW, Huh R, Chung SS. Unusual causes and presentations of hemifacial spasm. Neurosurgery. 2009;65(1):130–7; discussion 137

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Duke Eye Center, Division of Oculofacial and Orbital Surgery, Durham, NC, USA

    Leon Rafailov & Ilya Michael Leyngold

  2. University of Utah, Salt Lake City, UT, USA

    Richard Lee Anderson

Authors
  1. Leon Rafailov
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  2. Richard Lee Anderson
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  3. Ilya Michael Leyngold
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Editor information

Editors and Affiliations

  1. Oculofacial Plastic Surgeons of Georgia, Suwanee, GA, USA

    J. Javier Servat

  2. Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, MI, USA

    Evan H. Black

  3. Beaumont Eye Institute, William Beaumont School of Medicine of Oakland University, Rochester, MI, USA

    Frank A. Nesi

  4. Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, MI, USA

    Geoffrey J. Gladstone

  5. San Antonio Military Medical Center/Wilford Hall Ambulatory Surgery Center, Department of Ophthalmology and Oculoplastic Surgery, San Antonio, TX, USA

    Christopher J. Calvano

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Rafailov, L., Anderson, R.L., Leyngold, I.M. (2021). Essential Blepharospasm and Hemifacial Spasm. In: Servat, J.J., Black, E.H., Nesi, F.A., Gladstone, G.J., Calvano, C.J. (eds) Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-41720-8_11

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  • DOI: https://doi.org/10.1007/978-3-030-41720-8_11

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