Muscle twitching under the eyes

Muscle twitching under the eyes is the main symptom of eyelid spasm. If this problem occurs, if the symptoms are mild and do not last long, no special treatment is required. However, if this symptom persists for a long time, active treatment is needed, otherwise if the condition worsens, it will have a greater impact on people. There are generally three methods to treat eyelid spasm: medication, botulinum toxin treatment and surgical treatment.

1. Drug treatment

This is also the first choice treatment for blepharospasm. Commonly used drugs include clonazepam, haloperidol, tiapride, benzhexol, etc. Some patients will have certain effects in the initial stage of the disease, but as the course of the disease prolongs, the efficacy will gradually decrease, or the patient will stop taking the drug because of intolerance of the side effects of the drug.

Oral medications include: (1) dopamine receptor antagonists, such as haloperidol, tiapride, inosine, etc.; (2) γ-aminobutyric acid drugs, such as valproate, sodium valproate, etc.; (3) anticholinergic drugs, such as antan, etc.; (4) tranquilizers, such as diazepam, clonazepam, etc.; (5) antidepressants, such as amitriptyline, apuram, etc.; (6) topiramate, the first dose is 25 mg/day, and the dose is gradually increased to 75 mg after 4 weeks, twice a day; (7) lumbar puncture: intrathecal injection of dexamethasone 5 mg + 1 vial of vitamin B12 + 1 vial of cerebroside carnosine, 2-3 times a week.

2. Botulinum toxin treatment

This is currently a relatively effective method for treating blepharospasm. It reduces the degree of spasm by injecting a certain amount of botulinum toxin into the upper and lower eyelids. The effect of botulinum toxin injection is obvious, but the duration of the effect varies from person to person, mostly between one to several months. After the effect becomes ineffective, the injection can be repeated. The biggest problem with the current use of botulinum toxin treatment is that some people are allergic to botulinum toxin, cannot accept the side effects of botulinum toxin, or the effect is not obvious, so botulinum toxin injection treatment is also limited in application.

3. Surgical treatment

What is certain at present is that in patients with bilateral blepharospasm, the descending nerve impulses from the facial nerve are significantly hyperactive, which is also the direct cause of blepharospasm. Therefore, surgical operations targeting the facial nerve attempt to weaken the significantly hyperactive descending nerve conduction. Good results can be observed in some patients, but not all patients can benefit from surgery. Therefore, the current surgical treatment is only a supplementary treatment option for patients who have not responded to drug therapy and botulinum toxin treatment, and the choice needs to be cautious.

Treatment of residual symptoms after surgery: Give the formula drug injection beside the superficial temporal artery + multiple injections into the eyelid muscle, once a day, one course of 14 days, generally repeated 2-4 courses, most of the patient's residual symptoms can be significantly alleviated or cured.