Benign blepharospasm
is characterized by episodes of spontaneous and uncontrolled blinking, usually
of one eye. There are other types of
blepharospasm, which are not benign, for example, if you get something in your
eye or, a more serious problem, when the spasm is associated with other
neurological abnormalities. In other words, a benign blepharospasm is simply a
spasm of the eyelid with no particularly known cause and no other neurological
involvement. These spasms may occur at any time and are often inconvenient and
sometimes embarrassing, since other people tend to spend their time watching
your eye twitch rather than listening to what you are saying. The good thing is that a benign blepharospasm
will usually subside spontaneously within 6 months. However, once again, a practitioner should
always be alert for other abnormal neurological signs that might become present.
If there are any associated neurological problems, the practitioner must refer
the patient to a neurologist for further evaluation.
For good or for bad, in western medicine, the only treatment for benign
blepharospasm is a Botox injection. Botox
injections are used for a lot of things.
Botox stands for botulinum toxin.
You may have read about people who ate something like cold potato soup
from a can and who died very quickly afterwards. This disease is called
"botulism". Often the can
itself is deformed by the gas producing Clostridia
botulinum. The toxin from this
bacterium paralyzes nerves and muscles including the diaphragm and results in
death. You will notice that on
containers of honey, there is a warning in fine print stating that this product
should not to given to children under 1 year old. This is because the honey may contain spores
of C. botulinum that produce the very
same toxin. Adults and older children make
sufficient gastric acid to destroy these spores, but infants do not and that
can result in “infant botulism”. Infant
botulism causes a loss of the normal sucking reflex requiring tube or
intravenous feeding, reduces the muscle tone making the infant “flaccid” which
is an absence of normal muscle strength and finally can paralyze the diaphragm
requiring the baby to be put on a ventilator until the toxin resolves, which
may take weeks to months.
This is the source of the Botox injection, which basically
paralyzes the local nerve and its muscle for a “therapeutic effect”. There are some good reasons for doing Botox
injections but one should consider the following suggestions. The first is that Botox should only be given for
a valid indication and when there is no other acceptable or alternative
treatment. Secondly, whoever is doing
the injections should be an expert with a proven track record. Finally, the side effects should be clearly
delineated in writing before injection.
For example, the most common side effects of Botox when used for
blepharospasm are ptosis or sagging of the upper eyelid (21%) and keratitis or
eye dryness (6%), which has the potential of causing permanent eye damage. The
latter can usually be prevented by continuous and frequent use of eye
lubricants, but here we are talking about months of prevention. There are also many other less common side
effects.
In general, for all of the above reasons, I would recommend doing
TCM before trying Botox for benign blepharospasm.