Prevention in neurology

Blepharospasm (BS) denominates a syndrome characterised by spasms of the m. orbicularis oculi. Here, we refer to a form of focal dystonia in the area of the eyelid closing muscles. Common atypical forms, the waxing and waning character of focal dystonias, modifying sensoric “tricks” and local changes (blepharochalasis, levator-desinsertion), rare and common differential diagnosis (e.g. ocular myasthenia, chronic tic disorders, mono-/achromatopsia) as well as associations with autoimmunune diseases (e.g. ocular myasthenia, dysthyroid ophtalmopathy) often confound ophtalmologists and neurologists. Diagnosis seems to be straightforward, if during the clinical examination chronic intermittent, involuntary forceful eyelid closure is documented. We postulated that a definition of BS as “chronic involuntary, intermittent forceful eyelid closure” is misleading and does not cover the whole spectrum of the disorder. We were also interested in a classification of BS, which may improve the nosology of this focal dystonia.