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Benign Essential Blepharospasm

Matthew J. Thurtell, Robert L. Tomsak

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Blepharospasm is an involuntary closure of the eyes that is caused by spasm of the orbicularis oculi. It can be isolated or associated with certain ophthalmic and neurologic disorders, such as progressive supranuclear palsy. In this chapter, we begin by reviewing the clinical features of benign essential blepharospasm and oromandibular dystonia (Meige syndrome). We next review the clinical features of apraxia of eyelid opening and hemifacial spasm, since these disorders can occasionally be confused with benign essential blepharospasm. Lastly, we discuss management options for benign essential blepharospasm, which include injections of botulinum toxin A into the orbicularis oculi and surrounding muscles.