Abstract

AbstractEssential blepharospasm is a severe, progressive bilateral facial spasm affecting older individuals. Its cause is unknown. As the disease becomes severely disabling, a trial of medical therapy (l-dopa) is justified. This often is not successful; if not, the preferred treatment is bilateral differential nerve resection with avulsion of the nerve branches. Although the response to surgical therapy is variable, it is presently the best treatment for the incapacitated patient who fails to respond to medical treatment.