• Bryan R. Costin
  • Mark R. LevineEmail author
  • Essam A. El Toukhy


Essential blepharospasm consists of bilateral involuntary spasmodic contractions of the orbicularis oculi and adjacent muscles of the face. It occurs in middle age and older, mostly affecting women. The condition can be most debilitating. Essential blepharospasm is believed to be a result of an organic neurologic disease with a psychologic overlay. The first line of treatment is botulinum toxin with a success rate of 90%. Failures can be effectively treated with myectomy.


Blepharospasm Hemifacial spasm Orbicularis oculi Apraxia of lid opening Botulinum toxin Myectomy Meige syndrome 

Suggested Readings

  1. 1.
    Costin BR, Sakolsatayadorn N, McNutt SA, Rubinstein TJ, Trichonas G, Rocha KM, et al. Dimensions and anatomic variations of the orbicularis oculi muscle in nonpreserved, fresh-frozen human cadavers. Ophthal Plast Reconstr Surg. 2014;30(2):198–200.CrossRefPubMedGoogle Scholar
  2. 2.
    Leyngold I, Berbos Z, Georgescu D, Anderson RL. Essential blepharospasm and hemifacial spasm. In: Black EH, Nesi FA, Calvano CJ, Gladstone GJ, Levine MR, editors. Smith and Nesi’s ophthalmic plastic and reconstructive surgery. 3rd ed. New York: Springer; 2012.Google Scholar
  3. 3.
    Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxins. J Clin Aesthet Dermatol. 2014;7:31–9.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Bryan R. Costin
    • 1
  • Mark R. Levine
    • 2
    • 3
    • 4
    Email author
  • Essam A. El Toukhy
    • 5
  1. 1.Cleveland Eye ClinicAvonUSA
  2. 2.Department of OphthalmologyCase Western Reserve University, School of MedicineClevelandUSA
  3. 3.Oculoplastic Section, Department of OphthalmologyUniversity Hospitals of ClevelandClevelandUSA
  4. 4.Cleveland Clinic FoundationClevelandUSA
  5. 5.Department of Ophthalmology, School of MedicineCairo UniversityCairoEgypt

Personalised recommendations