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Acupuncture
For Blepharospasm
Mahesh R. Dave,MD
OBJECTIVE
To describe the use of needle acupuncture and microcurrent therapy for
treatment of blepharospasm.
KEY WORDS
Blepharospasm, Microcurrent Therapy, Acupuncture
INTRODUCTION
Blepharospasm is an ocular condition in which involuntary spasms or
closure of the orbicularis occulimuscles may cause frequent eye blinking
or even the inability to open the eye. Various treatments have been
recommended, including botulinum toxin injections,1-4 myectomy,1 and
drug therapy.1 Each therapy has its own success and limitations. For
example, serious cases of necrotizing fasciitis5 and ptosis have been
reported with botulinum toxin injections.
Blepharospasm, hemifacial spasm, Parkinson’s disease,6 and other
dyskinesic-dystonic movement disorders may share pathways through basal
ganglia structures. Acupuncture may offer an important avenue to approach
blepharospasm7 and other movement disorders.8 A case of essential blepharospasm
that did not respond to conventional ophthalmologic treatments is presented
herein.
History
The patient was a 51-year-old woman who developed facial and eye twitches
which gradually increased over 1 year. Gabapentin, propranolol, and
cyclobenzaprine were ineffective; spasms worsened. An ophthalmologist
injected botulinum toxin 4 times. Her symptoms improved mildly, but
then the twitches became more significant. Her eye blinks and facial
twitches worsened, and she lost peripheral vision.
Clinical Information
Findings of the physical examination were within normal limits. Results
of laboratory testing were in the normal range, including com-
plete blood cell count, urinalysis, thyroid profile, and muscle enzymes.
Tourette’s disorder was ruled out. The patient was not taking any
preparations such as methylphenidate, amphetamines, antipsychotics,
or illicit drugs (which can cause tics). The neurologic examination
revealed ocular and some facial twitches. The patient’s cranial
nerves were intact and Bell’s palsy was ruled out.
TREATMENT
Treatment included needle acupuncture of ST 2, 3; SI 18; TE 22; LI 3;
GB 34; and Extra Meridian points (Yin-Tang, GV 20 + shishenkong). Microcurrent
therapy was administered on the right side of her face at 5 and 80 Hz,
working with certain groups of facial muscles. Kidney channel tonification
also was performed.9,10
Outcome
Patient consent was obtained and the patient tolerated all procedures
well. There were no adverse effects. Total time span of treatment was
slightly less than 2 months. The patient showed >95% improvement,
sustained after 3 months of no further treatments.
CONCLUSION
Acupuncture can be an effective treatment in difficult cases of blepharospasm,
particularly when partial paralysis of ocular muscles due to botulinum
toxins is responsible for continuation of blepharospasm. Acupuncture
may offer an important avenue for the treatment of certain movement
disorders. Further research is necessary and desirable into the effectiveness
of acupuncture for this condition.
REFERENCES
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Anderson RL, Patel BC, Holds JB, Jordan DR. Blepharospasm: past,
present, and future. Ophthal Plast Reconstr Surg. 1998;14:305-317.
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Carruthers A. Update on botulinum toxin. Skin Therapy Lett. 1999;4:1-2.
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.
Boghen DR, Lesser RL. Blepharospasm and hemifacial spasm. Curr Treat
Options Neurol. 2000;2:393-400.
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Mezaki T, Kaji R, Brin MF, et al. Combined use of type A and F botulinum
toxins for blepharospasm: a double-blind controlled trial. Mov Disord.
1999;14:1017-1020.
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Latimer PR, Hodgkins PR, Vakalis AN, Butler RE, Evans AR, Zaki GA.
Necrotising fasciitis as a complication of botulinum toxin injection.
Eye. 1998;
12(pt 1):51-53.
-
Young R. Update on Parkinson’s disease. Am Fam Physician. 1999;59:2155-2167,
2169-2170.
-
.
Nepp J, Wenzel T, Kuchar A, Steinkogler FJ. Blepharospasm and acupuncture:
initial results of a treatment trial [in German]. Wien Med Wochenschr.
1998;148:457-458.
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Jayasuriya
A. Clinical Acupuncture. 7th ed. New Delhi, India: B. Jain Publishers
Ltd; 1998:458, 477.
-
Helms JM. Acupuncture Energetics: A Clinical Approach for Physicians.
Berkeley, Calif: Medical Acupuncture Publishers; 1995.
-
Helms JM. Acupuncture for Physicians Course and Handbook. Bethesda,
Md; January 1999.
AUTHOR
INFORMATION
Dr Mahesh Dave specializes in Adult and Child Psychiatry, Addiction
Medicine, and Forensic Psychiatry in Bryan, Texas.
Mahesh R. Dave, MD*
1201D Briarcrest Dr
Bryan, TX 77802
Phone: 979-776-5600 • Fax: 979-776-6280 • E-mail: mana@tca.net
*Address all correspondence and reprint requests regarding this article
to Mahesh Dave, MD, at the address above.
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