What are other therapies for blepharospasm when Botox injections doesn't answer?

Answer 1

The surgical alternatives to Botox® include orbicularis muscle stripping or selective facial nerve avulsion, both of which carry substantial risk of permanent disfigurement without necessarily controlling the spasms. More info at www.blepharospasm.org I've been working for an oculoplastic surgeon Jeffrey Paul Edelstein,MD and this problem is more common than you'd think, we see this in patients pretty regularly. The spasms are more common in women than men, and are covered by Medicare and other insurances, including Humana and United for sure. Anyone in the western half of the US could contact us if they needed to. Our office is in Chandler AZ. 480 962 9121 www.jpemd.com ************************************* I would also like to know if there are any new treatments. Botox is a temporary fix and save the first week or so after treatment I can have just as much trouble with the spasms as with out the treatments. I have not tried Clonezepam. One thing that has helped me is Diphenhydramine or Benedryl. This is also the ingredient in Simply Sleep or Tylenol PM. I don't know how or why it works other than I tried using it to take frequent naps since that was my only relief during the first few months of trying to stabilize the condition and get some form of functionality back. I have used it for about two years now and have had decent results. In that time period I have made several driving trips from Colorado to NH and attended 2 motorcycle weeks at Laconia and was able to ride my motorcycle without too much trouble. Only occasional flare ups and non at critical times like heavy traffic. I have found that even though the medication helps I still suffer from muscle fatigue in my eye area as well as in my jaw. Also for me a key factor is how well I am breathing. I can gain some relief from blowing my nose and concentrating on breathing PROPERLY. Notice I did not say normally and that is because I feel that my normal breathing is not normal and is also a factor, along with stress and fatigue.

Answer 2

First of all, the success of Botox for blepharospasm depends on dosage, placement sites, and skills and/or techniques of the injecting physician. It can take several Botox cycles experimenting with dosage and placement, and sometimes trying out more than one injector, before optimal results are achieved.

Botox is dependent upon zinc, so if you have a zinc deficiency, that can negatively affect your results. There is a brand new prescription on the market that you can take a few days before injections to boost your zinc levels. Others have achieved similar results by eating a lot of turkey in the four days prior to injections.

There are other brands and strains of botulinum toxin that can be tried, such as Xeomin, Dysport, and Myobloc. Some patients have limited relief with any one of a variety of oral medications, such as clonazepam. When these avenues fail, there are surgical procedures that may be considered, such as limited myectomy or frontalis sling.

To learn more about these kinds of therapies, visit the Benign Essential Blepharospasm Research Foundation at blepharospasm.org. There is also a link toward the bottom of that page to a bulletin board where you can communicate with others who suffer from BEB.