Effective Treatment Options for Blepharospasm and Meige’s Syndrome

Blepharospasm is a condition due to involuntary blinking or spasm of the eyelids. The cause is unknown and not life threatening. However, an abnormal function of the basal ganglion is associated with this condition. Patients with blepharospasm have normal eyes, but may have visual problems due to eyelid closure. Some patients have sensitivity to light and fatigue. When blepharospasm is combined with involuntary movements of the mouth, tongue or jaw, the condition is known as Meige’s Syndrome. Another name is Cranial Dystonia or Oral Facial Dystonia.

The following cosmetic and reconstructive treatment options are available for Blepharospasm and Meige’s Syndrome:

Botulinum Toxin

Botulinum A toxin is a product of the bacteria, Clostridium botulinum. A prescription form of this toxin is called BOTOX Cosmetic (onabotulinumtoxinA), an approved treatment for blepharospasm in persons 12 years and older. BOTOX is injected into the eyelid and paralyzes the muscles of the eyelid. Significant improvement has been shown in patients by reducing spasms and weakening the eye muscle. Results may last up to three months. There are warnings and precautions when receiving this product. With 95% of patients showing improvement, Botulinum toxin is the most effective treatment option for relieving symptoms.

Surgical Techniques

A myectomy is an option when BOTOX treatments fail to show improvement or a patient cannot receive botulinum toxin. A myectomy is a surgical reconstructive procedure to remove eyelid and brow muscles. This is a multi-stage procedure and upper eyelid and brow muscles are removed first. If no improvement is seen, a lower eyelid myectomy will follow at a later date. This procedure is usually done under local or general anesthesia. After surgery, the patient will be able to open their eyes completely. Swelling, bruising, and numbness of the forehead may occur after surgery. Visual disability improves over time and may take up to a year for complete recovery.

Superior Cervical Ganglion Block

The Superior Cervical Ganglion is a group of ganglia of the sympathetic trunk that lies on each side of the neck. Located just below the skull, these ganglia provide sympathetic innervation to the face, head and neck. Blockage of the superior cervical ganglion can reduce the sensory symptoms such as light sensitivity (photo-oculodynia) and treat associated pain.

Blepharospasms and Meige’s syndrome may be initially diagnosed by an Ophthalmologist or Neurologists due to the symptoms presented by the individual. Certain treatments will require a board-certified cosmetic surgeon or reconstructive plastic surgeon to correct cosmetic deformities and restore eyelid and facial function.