Spontaneous remissions and exacerbations are possible, but for most patients the disease is chronic. Dry eyes, in particular, may be the cause of eyelid spasm or can aggravate coexisting essential blepharospasm. Treatment of dry eye or other ocular conditions may reduce eyelid spasm to a level that the patient can tolerate without the need for additional medications or injections. A related disorder, hemifacial spasm, involves involuntary spasms of muscles on only one side of the face. This problem usually is caused by abnormal stimulation of the facial nerve, which travels from the brain to the facial muscles.
Hemifacial spasm responds satisfactorily to botulinum toxin injections in most patients.
If the spasms are severe, a neurosurgical operation can be done to prevent the facial nerve from being abnormally stimulated.