Reconstructive
Surgery
Facial Spasms (Eyelid
Spasm) and Botulinum Toxin
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:
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 time 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 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.
Other Procedures:
Other commonly performed reconstructive procedures
include correction of
Eyelid Lift (Blepharoplasty),
Entropion,
Ectropion,
Eyelid Drooping,
Eyelid and Skin cancer reconstruction,
Facial Paralysis,
Watering Eyes,
Thyroid Eye Disease,
Orbital Surgery,
and Trauma and Maxillofacial Surgery
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