Introduction

The muscles of facial expression and the eyelid are normally under our voluntary control. Facial spasm is a condition in which these muscles function abnormally and are no longer under the direct control of the brain. It can affect either one small area of the face, or the entire face including the neck. Four distinct forms of facial spasm are known:

Types of Spasms

 Benign Essential Blepharospasm (BEB) is caused by an uncontrolled nerve signal in the brain that stimulates the eyelid muscles. Constant involuntary blinking and squeezing of the eyelids causes visual interruptions in the patient’s day to day activities. Hemifacial spasm (HFS) is commonly caused by an irritation of facial nerve on one side, leading to involuntary spasms on one half of the face. Meige syndrome involves spasms over the entire face. Myokimia is a more localized form of spasm, that typically involves a single eyelid or periocular area. Botunlinum toxin injection (BOTOX) into the eyelid muscles can significantly reduce the muscle spasm that causes contraction or twitching of the eyelids.

Injection and Recovery

Injection procedure is performed as an out patient procedure, and takes 10 minutes. Application of local anesthesia cream an hour before the procedure makes it almost painless. The effect takes 7-10 days, and can last for 3-4 months.

Note

Botulinum toxin only controls the spasm, and does not treat it. Therefore, repeated injections are required for continued effect. Some patients may be non-responsive to Botox, and would need surgical correction of spasm.

Insurance

When used for treating spasms, Botulinum toxin is covered by medical insurance.
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Diagram showing the facial muscles which are involved in facial spasms.

 

Case of Benign Essential Blepharospasm (BEB) treated with Botulinum toxin injection.

Case of Benign Essential Blepharospasm (BEB) treated with Botulinum toxin injection.

Case of Benign Essential Blepharospasm (BEB) treated with Botulinum toxin injection.

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