Benign Essential Blepharospasm Medication

Updated: Nov 17, 2022
  • Author: Robert H Graham, MD; Chief Editor: Edsel B Ing, MD, PhD, MBA, MEd, MPH, MA, FRCSC  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.


Botulinum toxins

Class Summary

Botulinum toxins help produce symptomatic improvement of orbicularis spasm and autonomic symptoms. The various botulinum toxins possess individual potencies, and care is required to ensure proper use and avoid medication errors, since they are not interchangeable. OnabotulinumtoxinA and incobotulinumtoxinA are both approved by the FDA for the treatment of blepharospasm.

OnabotulinumtoxinA (Botox)

Treats excessive, abnormal contractions associated with blepharospasm. Binds to receptor sites on motor nerve terminals and inhibits release of ACh, which, in turn, inhibits transmission of impulses in neuromuscular tissue. It is indicated for the treatment of blepharospasm associated with dystonia in patients aged 12 years or older.

IncobotulinumtoxinA (Xeomin)

Botulinum toxin type A that is free of complexing proteins found in natural toxin from Clostridium botulinum. Acetylcholine release inhibitor and neuromuscular blocking agent. Indicated as first-line treatment for blepharospasm in adults.