Blepharospasm is an uncontrolled spasmodic contraction of the orbicularis muscles of the eye resulting in an abnormal tic or twitch of eyes. It usually lasts for seconds to minutes but in severe cases eyes may be closed for hours. It may be essentially benign or secondary due to a lesion in basal ganglia, pyramidal tract, and trauma, local pathology in the eyes or drug induced. Here we are presenting a case of psychogenic blepharospasm. A 65 year old woman presented with a history of episodic inability of opening her eyes for the past 6 months. She had repeated abrupt closure of eyes which would persist for 1 hour. It made her socially and interpersonally disabled. Systemic and neurological causes were ruled out by detailed physical examinations and investigations including neuroimaging. Following poor response to oral medications she was injected with 7 units of Botox only in the muscles of the right eye. But within seconds she received relief in both eyes. During the next session she received a needle prick in one eye with no medication and immediately both of her eyes opened from a tightly closed position. In this case the patient reported stress due to increased workload around the house. From our case it depicts that a true movement disorder is often difficult to distinguish from functional disorder. So evaluation and management of patient's external and internal stress will be of immense help before conducting any invasive treatment.
眼睑痉挛是眼轮匝肌不受控制的痉挛性收缩导 致眼睛异常抽动或抽搐。它通常持续几秒钟到几分钟， 但在严重的情况下，眼睛可能会紧闭数小时。它可能 是良性的，无论是原发的还是继发于基底节、锥体束 的病变，眼部的创伤或局部病理情况引起的，或是药 物所致的。在这里，我们报告一例心理性眼睑痉挛的 病例。患者，女性，65 岁，发作性无法睁眼6 个月。 她反复出现突然闭眼，往往要持续1 h。这使其无法人 际交往，社会功能受损。详细的体检、包括神经影像 学在内的检查排除了神经系统或其他系统性病因。口 服药物治疗效果不佳，只在右侧眼睑肌射7 个单位的 肉毒素，几秒钟内，其双眼症状均得以缓解。之后一 次治疗时，只用针刺一下一只眼睛，无需任何药物或 暗示，患者就睁开紧闭的双眼。本病例中，患者曾报 告过最近家务繁重感到有压力。这一病例表明，真正 的运动障碍与功能性障碍鉴别往往有一定难度。因此， 在进行任何有创治疗之前，评估患者的内外应激，并 对此处理，将获益匪浅。.
Keywords: Blepharospasm; India; functional disorder; movement disorder; psychogenic.