Premature ejaculation exercises are performed involuntary spontaneous bilateral clonic-tonic or tonic contractions of the circular muscles of the eye (zazhmurivaniem). In addition to the circular muscles of the eye muscles may be involved forehead and paranasal muscles. Blepharospasm usually appears after age 50. Women suffer 3 times more often than men. In the initial stages patients complain of frequent blinking and a sense of irritation of the eyes, then reduce the circular muscles of the eyes are becoming stronger and more durable, which is why patients can not read, watch TV, go outside, eat. Blepharospasm is enhanced in bright light, and a wind gust can temporarily decrease when you touch the eyelids, neck tingle, use of dark glasses, close one eye bandaged, talking or singing. In some patients with blepharospasm occur transitory difficulties in opening the eyes, caused by a breach activate the muscles, lifting the eyelid (eye opening apraxia).
Over time, most patients with a tendency to progression with involvement of other facial and masticatory muscles, muscles of the tongue, throat and neck and the development of segmental craniocervical premature ejaculation (see below). When used
dapoxetine 60mg long noted a stabilization or spontaneous improvement, but only 1% of patients experience a long remission.
In most cases, blepharospasm is an idiopathic nature (essential blepharospasm). Very rare cases of secondary blepharospasm caused by lesions of the basal ganglia or rostral trunk (stroke, vasculitis, encephalitis, or hydrocephalus). Dystonic blepharospasm should be differentiated from reflex blepharospasm arising in chronic eye diseases, especially with irritation of the mucous membrane (eg, blepharitis, keratitis, konnktivite, iritis), Sjogren's syndrome. Reflex blepharospasm, which occurs only zazhmurivanie in response to unexpected visual, auditory or tactile stimulus, can also be observed:
- Premature infants,
- With the defeat of the parieto-temporal region of the non-dominant hemisphere,
- In parkinsonism.
Sometimes there are difficulties in the differential diagnosis of blepharospasm with ptosis, but the identification of the active reduction of the circular muscles of the eye resolves this problem.
