| Identifier |
spasms_when_to_image_them |
| Title |
Spasms: When to Image Them |
| Creator |
Andrew G. Lee, MD; Michael Duan |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (MD) Class of 2021, Baylor College of Medicine, Houston, Texas |
| Subject |
Blepharospasm; MEIGE; Myokymia |
| Description |
Summary: • Benign essential blepharospasm o Bilateral, simultaneous spasm of the eyelids, looks like excessive blinking o Idiopathic, benign, does not require imaging • Meige Syndrome o Spasm of both the eyelids and the face, can descend to the lower face • Hemifacial spasm o Spasm of one entire half of face o Caused by compression of the facial nerve, so imaging is required with MRI/MRA o Typically, a structural lesion, can be caused by tumor or vascular anomaly • Myokymia; o; Independent and involuntary firing of the muscle unit o Most common form is lower lid myokymia, presents as twitching of lower lid, imaging not required -Caused by stress of drinking too much caffeine o Facial myokymia often involves compression of the facial nerve, so imaging is required • All abnormal movement disorders discussed can be treated with botulinum toxin. |
| Transcript |
So, we're talking about abnormal movements today, and the main ones we're going to concentrate on are benign essential blepharospasm. And today we have a special guest with us, Misha, who is our medical student who's going to demonstrate each of these for you. So benign essential blepharospasm is bilateral, simultaneous, and its literally spasm of the eyelids, and Misha will now demonstrate what it looks like. So, both eyes spasm, it looks like excess blinking. And benign essential blepharospasm is benign and it's essential because it's idiopathic and it doesn't really need to be imaged. However, if it's in the face we don't call it blepharospasm anymore. We add the eponym Meige (M-E-I-G-E) so if it's the eyelids and the face, Meige syndrome and it can go down into the lower face as well. If, however, it's just one half of your face, that we call hemifacial spasm. So, Misha will now demonstrate the hemifacial spasm. So, it's spasm of the entire half of one space and hemifacial spasm is caused by compression of the facial nerve causing the facial spasm, the seventh nerve, and so we do image hemifacial spasm as opposed to benign essential blepharospasm which we don't have to image. And the reason is there's usually a structural lesion. And one of the things that could cause it is a tumor, cerebellopontine angle tumor, but also (???) or a little vascular anomalies at the root exit zone of the seventh as it's exiting the pons could compress on the seventh and cause hemifacial spasm. And then we have myokymia. Myokymia is the muscle unit is firing independently and involuntarily. The most common is lower lid myokymia. It's benign and Misha can try and demonstrate this with her hand. So, it's like twitching of the lower lid, this twitching of the lower lid or the upper lid sometimes. It's involuntary it's like a little tiny twitch and we don't image lid myokymia. However, if it goes into your face, it's like often described like a bag of worms. The patient has a rippling muscle effect inside of their face, we do image facial myokymia. So that often is something compressing the seventh nerve and leading to the abnormal movement. So, in summary we can have both eyes, spasming of the lids, blepharospasm, benign, don't image it. It can go into your face, Meige. It can be just one half of your face having facial spasm, image that. We use MRI/MRA, something pressing on the seventh nerve. There's lid myokymia which is super common and caused by stress or drinking too much caffeine, I have it myself. It's benign, we don't image that. But if it goes into your face, image that. All of these things can be treated with botulinum toxin. |
| Date |
2019-10 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890 |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6dz50wf |
| Setname |
ehsl_novel_lee |
| ID |
1469327 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6dz50wf |
