Surgical therapy for blepharospasm

Over the past 3 1/2 years, 28 patients with blepharospasm have undergone, bilaterally, staged percutaneous thermolytic fractional destruction of branches of the facial nerve. This series consisted of 20 women and eight men ranging in age from 40 to 79 years, with symptoms for from 1 to over 10 years. At the time of follow-up, 12 patients had undergone one operation, 12 had had two operations, and four had had three to five operations. Sixteen of the 28 patients obtained excellent to good relief of symptoms for 1 to 3 1/2 years. The procedures performed using local anesthesia and intravenous analgesia allow the immediate recognition of any facial muscle weakness or asymmetry. The findings indicate that this procedure, in many patients with minimal complications, can significantly relieve the incapacitating symptoms of blepharospasm.