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Eyelid and Facial Squeezing Disorders

Several facial and eyelid squeezing disorders are treated by our oculoplastic surgeons. These disorders include:

  • Blepharospasm (BEB) – Blepharospasm is characterized by bilateral involuntary eyelid spasms, which sometimes affect other facial muscles as well. The cause for blepharospasm is unknown but is thought to be a neurodegenerative disease such as Parkinson’s.
  • Hemifacial spasm (HFS) – Hemifacial spasm is characterized by involuntary twitches occurring on one side of the face. This can be sometimes caused by compression of the facial nerve (the seventh cranial nerve – responsible for movement of the eyebrows, eyelids and mouth) by tumors or vascular lesions. However, hemifacial spasm is fairly rare and in most patients a direct cause cannot be identified.
  • Meige syndrome (lower facial dystonia) – A rare disorder characterized by involuntary muscle contractions in the jaw, tongue and eyes, Meige syndrome is a combination of two forms of dystonia: oromandibuar dystonia (OMD) and blepharospasm.
  • Aberrant regeneration (AR) – AR is similar to hemifacial spasm in that it is usually unilateral and can involve both the upper and the lower face. Occurs after recovery from Bells’ or other forms of facial nerve palsy when the facial nerve function is abnormal with miswiring and excessive stimulation of the facial muscles.   

Treatment for eyelid and facial squeezing disorders

Many disorders that cause spasms of the face can be treated with Botox® injections, but severe cases of belpharospasm, especially those associated with apraxia of lid opening, require surgical intervention. Myectomy surgery is the procedure of choice for severe squeezing not responding to Botox® injections, although surgery is sometimes needed to correct the associated droopy eyelids and brows and improve the dry eyes by tightening the lower lids.

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