What is the role of a superior cervical ganglion block in the treatment of benign essential blepharospasm (BEB)?

Updated: May 20, 2019
  • Author: Robert H Graham, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

Treatment of BEB focuses heavily on reducing the motor component of the disease. Remember that there is also a sensory loop of the disease, which is harder to quantify because it involves the patient's subjective complaints of ocular surface irritation and photosensitivity. In some patients in which BOTOX® treatment fails, a careful history and examination reveals that BOTOX® does reduce spasm and weaken the orbicularis muscle but does not relieve the sensory symptoms of the disease. For patients who complain of debilitating light sensitivity (photo-oculodynia) intervention by a pain clinic may benefit the patient.

Two reports have demonstrated reduction of photo-oculodynia after superior cervical ganglion blocks to chemodenervate the orbital sympathetics. These preliminary studies suggest that the sympathetic nervous system may play a role in maintaining the afferent loop of the disease. [66]


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