Blepharospasm (Eyelid Twitch)

What is blepharospasm, and what are my treatment options?

The neurologists at OrthoNeuro treat various neurological disorders, including blepharospasm.

In addition, they answer questions and provide health information to help you understand your needs and identify the best treatment option.

Read more to learn what blepharospasm is and how to treat it.

What Is Blepharospasm?

Blepharospasm is a rare neurological disorder. It includes abnormal eye twitching, eyelid spasms, or involuntary eyelid closure. The spasms occur in the orbicularis oculi muscle, the muscle responsible for blinking. 

It is common to blink 10 to 20 times per minute, or a little less when you are concentrating. If you have an increase in blink frequency and strength, it is called blepharospasm.

Blepharospasm is classified as a type of focal dystonia. This means that dystonia or abnormal, unintentional, sustained involuntary muscle spasms occur in a focal point of the body. 

In the case of blepharospasm, it affects the muscle around the eye. The spasms could last from seconds to minutes, and it tends to happen more in your upper eyelid. However, the spasms can be so severe that they can cause pain and prevent you from seeing.

There are many different types of blepharospasm. The term can be used to describe any abnormal blinking or eyelid spasm.

This includes blinking caused by eye irritation, injury, medications, and nervous system disorders.

The blepharospasm mainly referred to in this article is called benign essential blepharospasm (BEB). The condition is more than just a common minor eyelid twitch that could be linked to fatigue or stress.

In more than half of all people with benign essential blepharospasm, the symptoms of dystonia spread beyond the eyes to affect other facial muscles and muscles around the body. At times, the facial nerve is affected, causing facial spasms.

What Causes Blepharospasm Twitching?

Primary blepharospasm, or benign essential blepharospasm (BEB), is a term used for eyelid twitching, fluttering, or blinking when the underlying cause is unknown.

Many accredit blepharospasm to the abnormal functioning of the basal ganglia, a pair of ‘junction boxes’ in the brain that help coordinate our movements.

How Is Blepharospasm Treated?


Tetrabenazine is sometimes used to treat severe movement disorders such as Huntington’s disease. While it has proven effective for some patients, it is not licensed for treating blepharospasm.


Botulinum toxin injections(Botox®) are the preferred treatment for blepharospasm. 

The injections are administered directly into the orbicularis oculi muscle. This treatment helps 90% of patients to relieve blepharospasm symptoms making it highly effective.

The healthcare professional will inject the botulinum toxin in four places along the upper and lower lids.

Usually, the injections are administered every three months.

There are usually no side effects; however, there may be a slight drooping of the eyelid. If the toxin leaks into the eye, there may be a period of double vision or dry eye. These symptoms are only temporary.


Surgery is usually only used when vision is seriously impaired caused by severe eye closure. If other treatments prove to be unsuccessful, the neurologist may suggest removing some of the muscles responsible for closing the eye.

Alternative Treatments

Wearing dark glasses can reduce environmental factors such as bright light that triggers the condition and make it less obvious to others. In addition, wrap-around glasses are most protective.

Voluntary maneuvers, such as pulling on or touching the eyelid, pinching the neck, talking, yawning, humming, or singing can be helpful.

OrthoNeuro’s highly skilled and experienced neurologist in Columbus, Ohio, provides quality care for you and your family.

The neurologist offers comprehensive neurological services, providing compassionate care and expertise to effectively understand and treat you or your loved one’s problems.

Make an Appointment with an OrthoNeuro Neurological Specialist Today!

If you have been experiencing experiencing eyelid twitching, schedule an appointment with one of our Board Certified Orthopedic Neurologists at one of our 7 convenient locations throughout Greater Columbus. 

We will evaluate your unique lifestyle and goals to determine which type of treatment is best for you. Best of all, most patients can be seen within 24 hours of making an appointment.

Our Neurologist

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