In February 2002 I began to have trouble keeping my eyes open. A friend of a friend said it sounded like what her old boss had – Dystonia. It got so bad I was having to push my eyelid up to get them open. By chance another friend was working with someone who used to be in the NHS and knew about Dystonia. He suggested I do a timeline. This showed that it began a few months after I took an anti-emetic (Domperidone) for a migraine.
Twelve cases of drug-induced blepharospasm improved within 2 months of psychotropic cessation Yuko Emoto, Hirofumi Emoto, Eriko Oishi, Syunichi Hikita, and Masato Wakakura Drug Healthc Patient Saf. 2011; 3: 9–14.
A 57-year-old woman presented with a 2-year history of difficulty keeping her eyes open, excessive blinking, eye irritation, and photophobia. For the previous 3 years and 9 months, she had been continuously treated with etizolam 4 mg/day for insomnia and anxiety. After 16–18 months of medication, she felt marked fatigue of her eyes. Voluntary closure of the eyes and sleep relieved this symptom. She tried to avoid sunlight and wind because of eye irritation. Her friends could not understand why she could not open her eyes and she began to avoid company. These symptoms made her more nervous and her insomnia got worse.
Meige’s syndrome: dyskinesia of the eyelids and facial muscles . Paulson GW ( 1972 ): Geriatrics 27: 69-78
Henri Meige described in 1904 what is now commonly called oral facial dystonia. There is some variation in what has been described since in what has been called Meige’s syndrome, but in all descriptions there is blinking and chin thrusting. Some patients have lip pursing or tongue movements and, for a few, the movements spread into the shoulders. The cause remains obscure, treatment less than ideal, and frustration is a major factor as it is with blepharospasm.
Many physicians, even regarding the more common essential blepharospasm, may have had no experience with Meige’s syndrome and the patient may be told the process is psychologic. It is not.
There are some similar conditions related to medication effects, for example, the mouth movement seen when excessive levodopa is present in patients with Parkinson’s disease.
Tardive dyskinesia, the movements that can follow prolonged use of major tranquilizers, can be associated with mouth and tongue movements.
Blepharospasm: a review of 264 patients F.Grandas, J.Elston, N.Quinn & C. D. Marsden J Neurol Neurosurg Psychiatry. 1988 June; 51(6): 767–772.
Most cases of blepharospasm have no other identifiable disease. In our series, an obvious cause was evident in only 14.3% of patients. These included Parkinson’s disease and other forms of Parkinsonism, neuroleptic-induced tardive dystonia, other drugs including levodopa and nasal decongestants may also precipitate blepharospasm. The cause of the blepharospasm was unknown in 226 of the 264 patients. In a small number of patients, blepharospasm was secondary to Parkinson’s disease (19 cases)…Fourteen of the patients were exposed to neuroleptic drugs prior to the onset of blepharospasm, developing tardive dystonia.