Thursday, October 8, 2009

Benign eyelid myokymia



  • precipitating factors such as fatigue, stress and excessive caffeine/alcohol/nicotine intake may result in irritation of the orbicularis’ nerve fibers

  • Medical-ocular history should be comprehensive and should include such questioning as antipsychotic medication usage, past CN VII palsy and prior injection in or around the eye

  • Patients should be observed for overt eyelid twitching in isolation, associated with speaking or accompanying facial/neck/limb involvement.

  • Anterior segment biomicroscopy will demonstrate contributory conditions such as trichiasis, blepharitis, keratitis, dry eye syndrome, corneal abrasion, recurrent corneal erosion and foreign body. In some instances, BEM will not be observed during the course of examination.

  • In these instances, superior oblique myokymia (SOM) should be ruled out. (While viewing the suspect eye under the slit lamp, the patient is directed to look down and in toward his or her nose. SOM, if present, will demonstrate subtle ocular oscillations lasting less than 10 seconds.)

  • Differential diagnosis of BEM includes blepharospasm, hemifacial spasm, Meige syndrome, aberrant regeneration of CN VII, trigeminal neuralgia, Tourette syndrome, spastic-paretic facial contracture and SOM.

  • antihistamine and antihistamine-combination products also proved successful in treating the condition.

  • severe cases of BEM, botulinum toxin A (Botox, Allergan) injection to the affected eyelid area has been used

1 comment:

Unknown said...

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