Can Eye Syndrome Cause Facial Grimacing; About ‘Meige Syndrome’

Tanu Sharma, B.Optom

Optometrist, Eye 7 Chaudhary, New Delhi, India

 

Introduction

Meige’s syndrome is a type of cranial dystonia characterised by blepharospasm and oromandibular dystonia, it can be associated with involuntary spasms of tongue, jaw, pharynx , face, and cervical muscle.⁽¹⁾

It can be characterised by the presence of bilateral dystonic spasms of the facial muscles and frequently of cranial muscles as well.

Meige syndrome is a form dystonia which is caused by a compressed or irritated facial nerve.⁽²⁾

In this article we talk about whether there is any syndrome which can cause facial grimacing or focal dystonic movement disorders identified as blepharospasm (double eyelid spasm).

As Dystonia is defined as abnormal involuntary posturing or body movements due to sustained muscle contractions, usually happens due to neurological reasons

Over time these muscle spasms and contraction may happen more and cause eyelids to close and make it harder to keep your eyes open.

Those with Meige syndrome can essentially become blind since their eyes are closed though their vision is unaffected.⁽³⁾

One study showed that Meige syndrome is characterised by the combination of upper and lower cranial involvement and including binocular eyelid spasm and involuntary movements of jaw muscles (oromandibular dystonia) as blepharospasm is a primary focal dystonia characterised by involuntary closure of eyelids and spasms of orbicularis oculi muscle which develop oromandibular dystonia which involves involuntary lower facial and masticatory movements including lip pursing, chewing, and jaw opening /clenching. ⁽⁴⁾

Another study recommends that Meige syndrome has a characteristic of shortness of breath with the assumption of the larynx and laryngeal involvement with respect to these researchers recommend routinely establishing if has a sign or symptoms of breathlessness. ⁽⁵⁾

As one study showed the feature of Meige syndrome is an involuntary spasm or writhing movements of the mid-face (cheeks), lower  face(mouth/tongue), and possibly extending down into the neck.⁽⁶⁾

Signs and Symptoms

• Blepharospasm “forced or frequent blinking or twitching happens when you are exposed to light”.
• Oromandibular dystonia “forced contractions of your jaw and tongue which male it difficult to open or close your mouth”.
• Facial Grimacing
• Thrusting of chin
• Displaced Jaw
• Jaw Pain
• Headaches⁽⁷⁾

Management

1. Medication – Pills used to treat Meige Syndrome include Clonazepam, Trihexyphenidyl, Diazepam and Baclofen.
2. Injections – Botulinum toxin are preferred to inject into muscles around the eye and jaw temporarily paralysing these muscles to reduce the involuntary spasms.
3. Deep Brain Stimulation – It is a low voltage way to produce sustained and long-lasting improvement of dystonia symptoms. DBS involves a thin metal electrode into a specific area of the brain and attached to an implanted computerised
4. Speech and Swallowing Therapy – Reduce the severity of spasms.
5. Stereotactic Brain Surgery ⁽⁸⁾

Conclusion

In the end we conclude that yes there is an eye disease which can cause your facial grimacing. If anyone can see a person with facial grimacing, suggest they visit a doctor and get a proper checkup. advise them to try chewing gum which helps to reduce symptoms or wearing glasses may help because some spasms are triggered by sun and wind and finally looking down which helps to reduce symptoms while looking up may trigger it.

 

References

1. Pandey, S., & Sharma, S. (2017). Meige’s syndrome: History, epidemiology, clinical features, pathogenesis, and treatment. Journal of the neurological sciences, 372, 162–170.
2. Tolosa, E., & Martí, M. J. (1988). Blepharospasm-oromandibular dystonia syndrome (Meige’s syndrome): clinical aspects. Advances in neurology, 49, 73–84.
3. Ma, H., Qu, J., Ye, L., Shu, Y., & Qu, Q. (2021). Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update. Frontiers in neurology, 12, 630221.
4. Ma, H., Qu, J., Ye, L., Shu, Y., & Qu, Q. (2021). Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update. Frontiers in neurology, 12, 630221.
5. Watson, N. A., Hicklin, L. A., & Marion, M. H. (2021). Breathing dystonia in Meige syndrome. Clinical parkinsonism & related disorders, 5, 100106. https://doi.org/10.1016/j.prdoa.2021.100106
6. http://studylib.net/doc/8421770/facial-and-eyelid-%E2%80%9Ctwitch%E2%80 %9D-disorders. [Last Accessed – 05th Jul 2023; 09:10pm AEST]
7. https://my.clevelandclinic.org/health/diseases/15783-meige-syndrome [Last Accessed – 05th Jul 2023; 09:07pm AEST]https://rarediseases.org/rare-diseases/meige-syndrome/ [Last Accessed – 05th Jul 2023; 09:15pm AEST]