New Jersey Blepharospasm Specialist Dr. Baljeet K. Purewal
Benign Essential Blepharospasm (BEB), which is also referred to as simply blepharospasm, is a rare neurological disorder characterized by spontaneous spasms of the orbicularis oculi muscle, which is the muscle that controls the eyelid. This disorder can cause unintentional blinking, twitching, narrowing and/or closing of the eyelid. Individuals who reside in and around New Jersey that have BEB visit Fresh Face & Eye to receive botulinum toxin injections (aka BOTOX shots) from Expert Injector Dr. Baljeet K. Purewal. These shots effectively address the symptoms associated with this disorder.
What Causes an Individual in New Jersey to Develop Blepharospasm?
Although the reason this disorder develops in the first place is unknown, researchers believe that BEB may be caused by an interaction between environmental factors and an individual’s specific genes.
Abnormal Function of the Basal Ganglia Causes the Symptoms Associated with Blepharospasm
The symptoms associated with BEB result when an abnormal function occurs in the basal ganglia, which is the region of the brain that controls the orbicularis oculi muscle, which is the muscle that opens and closes the eyelid.
Does an Individual’s Age Play a Factor in the Risk of Developing Blepharospasm?
Yes, BEB usually affects people who are in their 40s, 50s and 60s. In addition, women are more prone to developing blepharospasm than men.
How Common is Blepharospasm?
Although this disorder is considered rare, according to the National Organization for Rare Disorders, approximately 2,000 new cases of BEB are diagnosed in the United States every year.
Can Blepharospasm Be Cured?
Currently, there is no cure for this disorder. However, there are a variety of treatments available, including BOTOX injections. With these injections, the muscle causing the symptoms the patient is experiencing is targeted so as to disrupt the communication between the nerve and muscle.
What Therapies Are Used for the Treatment of BEB?
There are natural therapies and oral medications that some people try to use to treat this disorder. However, neither of these are as effective as botulinum toxin injections are for the treatment of blepharospasm.
Surgical intervention is another potential treatment for BEB however, treating this disorder with surgery is extremely rare and usually only indicated if the BOTOX shots are unsuccessful in addressing the symptoms of blepharospasm.
How Effective is Oral Medication for the Treatment of BEB?
The oral medications (e.g., trihexyphenidyl, clonazepam, etc.) that are indicated for the treatment of BEB are only helpful for approximately 15 percent of those who take them. Furthermore, each medication has its own potential side effects, the results these medications produce are typically unpredictable and any relief that is achieved is generally short-lived. For these reasons, BOTOX injections are the recommended treatment for BEB.
Are the Natural Therapies Used for Blepharospasm Effective?
Some of the natural therapies people have tried to reduce the symptoms associated with BEB include acupuncture, biofeedback, chiropractic care, hypnosis and nutritional therapy. It has yet to be proven whether there are any benefits attained with these kinds of alternative therapies. However, the botulinum toxin injections are proven to be an extremely effective treatment for blepharospasm.
How Effective is BOTOX for the Treatment of BEB?
BOTOX injections are an effective solution for 80 percent of the patients who choose to have this treatment to relieve the symptoms associated with blepharospasm. Furthermore, treatment results usually last for several months.
Why is BOTOX the Preferred Treatment for BEB?
BOTOX’s high success rate in conjunction with its ability to provide blepharospasm patients with result longevity are two of the reasons that BOTOX injections are the preferred method for the treatment of BEB.
What is BOTOX?
BOTOX consists of botulinum toxin, which is a protein that is widely used in medicine for the treatment and prevention of a variety of conditions (e.g., overactive bladder, migraine prevention, etc.).
How is BOTOX Used at Fresh Face & Eye?
BOTOX is a prescription medication that is used to treat specific signs of aging in the face and the neck. In addition, Expert Injector Dr. Purewal uses BOTOX to treat the spontaneous muscle spasms that occur with BEB.
Is BOTOX Safe for the Treatment of Blepharospasm?
Yes, the United States Food and Drug Administration (FDA) has approved BOTOX for the treatment of BEB in patients who are at least 13 years of age.
In addition, BOTOX’s safety profile is excellent and there are no long-term side effects associated with these treatments.
How Does BOTOX Treat Blepharospasm?
Since BOTOX has the ability to disrupt the signal sent from the nerve to the muscle, once injected, the nerve is unable to direct the muscle to move. Therefore, after a patient has an Expert Injector, like Dr. Baljeet Purewal, perform targeted injections of botulinum toxin into his or her orbicularis oculi muscle, the communication between the nerve and the muscle is disrupted, thus, allowing the overactive eyelid muscle to relax.
Recognizing the Early Signs and Symptoms of Blepharospasm
Involuntary blinking, eyelid twitching, narrowing (i.e., squinting) and/or full eye closure can occur when the orbicularis oculi muscle begins to spasm.
Recognizing the symptoms of BEB early and seeking treatment right away can eliminate the current symptoms and prevent the onset of those that are more severe.
During the early stages of this disorder, individuals may experience eyelid irritation and discomfort. They may also notice an increase in the number of times that they blink.
Other early symptoms include:
- Sensitivity to light.
- Dry eyes.
- Eye pain.
- Eyelid heaviness.
- Eyes that water.
- Tension around the eyes.
- Frequent squinting.
- A sore sensation around the eyes.
Initially, the involuntary blinking associated with blepharospasm is mild, occurring intermittently. Nonetheless, as time passes, the symptoms may become more severe and occur more frequently.
Although BOTOX is an effective treatment for all individuals in the New Jersey area who have BEB, early diagnosis and treatment may help prevent the progression of the physical symptoms associated with this disorder.
Does Blepharospasm Affect Both Sides?
Most individuals with this disorder experience symptoms on both sides, however, BEB can affect only one side. Some patients with this disorder also experience spasms in their face and neck.
What is Functional Blindness?
Since blepharospasm affects the eyes, it can cause what is referred to as ‘functional blindness,’ making it an extremely challenging disorder to live with. Functional blindness is a term used to describe an individual experiencing a form of blindness that is not caused by the eye itself, but by a function of the eye (e.g., uncontrollable eyelid movements, etc.).
How is Blepharospasm in New Jersey Diagnosed?
A BEB diagnosis is confirmed through a clinical exam in which the specific signs and symptoms of the disorder are present.
If Someone Has Blepharospasm, Is There Anything That Can Trigger Symptoms?
Yes, this disorder can have triggers.
Some of the most common triggers for the onset of BEB symptoms include:
- Prolonged screen time.
- Sleep deprivation.
- Excessive caffeine consumption.
Besides the disruption BEB causes in the patient’s quality of life and work-related activities, from a safety perspective, when the disorder is triggered by driving or walking around New Jersey, it can also be dangerous.
Who Should Avoid BOTOX Treatments for BEB?
Individuals who are allergic to botulinum toxin or any of the other ingredients in BOTOX are not good candidates for this treatment. Additionally, individuals who have had a reaction to another botulinum toxin product (e.g., Xeomin, Dysport or Myobloc) should not have BOTOX injections.
Individuals with an infection at the injection site need to wait until the infection has cleared to have their injection session.
An Initial Consultation with Dr. Baljeet Purewal at Her New Jersey Practice
During the initial consultation, patients need to inform Dr. Purewal if they have any type of nerve and/or muscle condition (e.g., Lou Gehrig’s disease, Lambert-Eaton syndrome, etc.). Individuals who have nerve and/or muscle conditions may have an increased risk of experiencing serious side effects following BOTOX injections. For this reason, it is essential that patients are candid with Dr. Purewal during this consultation.
Dr. Baljeet K. Purewal needs a list of the prescription medications the patient takes. This list should include the name of the medication, dosage, frequency and reason the medication is prescribed.
Patients should also include any over-the-counter medications, vitamins and herbal supplements they take on their list. This information is extremely important because serious side effects can result when certain medications are taken while using botulinum toxin. In addition, patients should refrain from starting any new medications following their BOTOX treatment. If a new medication is indicated, patients need to inform the physician who is planning to prescribe the medication that he or she has previously had injections of botulinum toxin.
Dr. Purewal also needs to know if the patient:
- Plans to have any type of surgery.
- Has already had some type of surgery on his or her face.
- Is having difficulty raising his or her eyebrows.
- Is experiencing drooping eyelids.
- Is having, or has had issues related to bleeding (e.g., excessive bleeding, blood clots, etc.).
- Is experiencing any type of muscle weakness in the forehead.
- Is experiencing any other kind of abnormal facial changes.
- Is pregnant or plans on becoming pregnant (BOTOX may or may not harm an unborn baby).
- Is breastfeeding or plans on breastfeeding (it is unknown whether BOTOX passes into breast milk).
- Takes sedatives.
- Has recently been given an antibiotic injection.
- Is taking allergy medicine or cold medicine.
- Takes muscle relaxers.
- Uses products that thin the blood (e.g., blood thinners, aspirin, vitamin E, etc.).
Patients need to let Dr. Purewal know if they have received treatment with another botulinum toxin product (e.g., Dysport, Myobloc or Xeomin) within the four months leading up to this consultation. Please let Dr. Purewal know the reason for the treatment and which botulinum toxin product was used (even if the product was used to reduce the signs of aging or to prevent migraines).
At Fresh Face & Eye, Dr. Baljeet K. Purewal can address blepharospasm using BOTOX injections. This nonsurgical treatment offers patients relief from the symptoms of BEB for months at a time.
What to Expect During a BOTOX Treatment for Blepharospasm in New Jersey
Since Dr. Purewal is an Expert Injector as well as an Oculoplastics and Reconstructive Surgeon who specializes in cosmetic eyelid surgery and nonsurgical facial rejuvenation, she is very familiar with all aspects of the face, including the orbicularis oculi muscle that surrounds the eye.
Dr. Baljeet Purewal uses BOTOX injections to treat this disorder. This treatment is performed using a slender needle. Following insertion, Dr. Purewal carefully injects the medication into the patient’s orbicularis oculi muscle. Dr. Baljeet Purewal targets the sections of the muscle that are located above and below the eye.
How Long Will It Take for the Symptoms of Blepharospasm in New Jersey to Diminish After a BOTOX Treatment?
The length of time it takes for the botulinum toxin to take affect after the treatment can range from a single day to two weeks.
After a BOTOX Treatment, When Will the Symptoms of BEB Return?
As long as the patient receives BOTOX injections at regular intervals, the symptoms associated with his or her disorder should remain dormant.
How Frequently Are BOTOX Injections Necessary for Treating Blepharospasm in New Jersey?
The results attained with these treatments usually last approximately three months, therefore, most patients have repeat injections three or four times a year.
Are There Any Side Effects Associated with BOTOX Injections for Treating BEB?
Yes, as with any procedure, there is always a potential for side effects.
The main side effects associated with using BOTOX injections for the treatment of blepharospasm include:
- Dry eye.
- A weakened eyelid muscle.
- Pain or discomfort at the site of injection.
- Neck pain.
- Inflammation of the eyelids.
- Drooping eyebrows.
Other extremely rare side effects include:
- Double vision.
- A drooping eyelid.
What Happens If Blepharospasm Is Left Untreated?
Without treatment, vision function may be affected. Although BEB does not affect the ability of the eyes themselves to see, the repeated spontaneous opening and closing of the eye negatively affects the individual’s ability to see. This is referred to as ‘functional blindness.’ Once treatment is sought, the individual’s vision returns to normal.
Could Blepharospasm Be Linked to Some Other Condition?
Yes, there are some serious neurological conditions that are known to cause BEB. These conditions include Tourette syndrome and Parkinson’s disease.
How Common Are Allergic Reactions to BOTOX?
Allergic reactions to BOTOX are rare and are more likely to occur in patients who have certain medical conditions (e.g., cerebral palsy, etc.).
Although allergic reactions are rare, it is important that patients know the signs and symptoms that could indicate they are experiencing an allergic reaction.
The symptoms of an allergic reaction include:
- Red welts that itch.
- Feeling faint.
- A rash.
- Asthma symptoms (including wheezing).
- Facial swelling.
- Inflammation of the tongue.
What If BOTOX Injections Are Ineffective?
For the 20 percent of individuals with BEB that BOTOX shots are unable to treat, surgical intervention may be their only option.
The surgical procedure used to treat this disorder is referred to as a myectomy. During this surgery, some of the nerves and/or muscles that control eyelid movement are removed. A myectomy improves symptoms in 75 to 85 percent of the people who have this procedure done to address BEB.
How Much Does a Blepharospasm Treatment Cost?
To find out how much a treatment for BEB will cost, individuals need to schedule an appointment with Dr. Purewal at her New Jersey practice, Fresh Face & Eye.
What is the Likelihood That Health Insurance Will Pay for BEB Treatments?
Possibly. Every insurance company is different, however, most companies (including Medicare and Medicaid) will cover medical BOTOX treatments for FDA-approved indications. Therefore, to find out if their insurance covers BEB treatments, patients should contact their company to inquire.
These injections can be life-changing for individuals with BEB and especially for those who have had the disorder for quite some time, but did not have a diagnosis. If you are experiencing the symptoms associated with this disorder, please contact Fresh Face & Eye today. Oculoplastics and Reconstructive Surgeon, and Expert Injector Dr. Baljeet K. Purewal can help you regain an unobstructed view of the world by using a BOTOX injection to relax the eyelid muscle causing your symptoms. Fresh Face & Eye is at 82 Main Street in Chatham. To make your appointment please call (973) 635-4000 today.