BLEPHAROSPASM

• Blepharospasm is a type of focal dystonia in which there is an involuntary contraction of the muscles of the eyelids causing the closure of the lids
• It is generally due to spasm of the orbicularis oculi (OO) muscles and occurs in a variety of disorders of the CNS, or may occur secondarily to ocular disorders
• Peak age of onset is between the fifth and the seventh decade
• Greater tendency to spread to adjacent body parts (usually within the first 5 years of history) than cervical and upper limb dystonia

 Blepharospasm occurs in two forms

Essential (spontaneous) Blepharospasm

• It is a rare idiopathic condition involving patients between 45 and 65 years of age

Reflex Blepharospasm

• It usually occurs due to reflex sensory stimulation through branches of the fifth nerve, in conditions such as:
  • Phlyctenular keratitis
  • Interstitial keratitis
  • Corneal foreign body
  • Corneal ulcers
  • Iridocyclitis

• Frequent blinking and irritation of the eye
• Dry or watering eyes
• Light sensitivity
• Oedema of the lids
• Spastic Entropion (in elderly people)
• Forceful opening of the jaw
• Retraction of the lips

• Physical examination -involuntary contraction of the muscles of the eyelids
• Medical history

• The causative disease should be treated to prevent recurrences
• Botulinum toxin injected subcutaneously over the orbicularis muscle
• Facial denervation - in severe cases

Ayurvedic Treatment

Internal Medicines

• Bhadradarvyadi kashaya
• Vidaryadi kashaya
• Dhanwanthara gritha

Procedures

• Massage - Dhanwanthara avarthi taila, ksheerabala (over eyelids and forehead)
• Mukha Abhyanga - Mahamasha taila
• Shasthika kizhi - Local application
• Nasya - Dhanwanthara avarthi
• Karna poorana - Bala taila
• Sirodhara - Vatasini taila
• Seka – Bala + Yashti + Eranda kashaya
• Agnikarma along forehead