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accmodative, blepharo, hemifacial spams

2 years ago I suffered a severe tbi. And some l of the complications are accmodative spasms, blepharospasm, and hemifacial spams. None of which I had before, and after 2 years of vision therapy there all considered permanent. I've been prescribed botox and atropine. The botox doesn't really help.  My question is, why wouldn't it show up on MRI'S or anything else when every doctor knows and can see it happening to me.  Sometimes the accmodative spasms last over 5 hours.  Blepharospasm lasting over 3 hours.  
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Thanks for the quick response, I forgot I wrote this.
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177275 tn?1511755244
The MRI does not show up every disease and every problem that mankind is subject to.  There are no characteristic findings of accommodative spasm (AcSp) or blepharospasm on MRI.    Botox should work but it needs to be injected by a skilled physician with extensive experience in blepharospasm and facial spasms. The dose of botox needs to be determined by trial doses that increase.

Your profile does not say where you live. Try and see a neuro-ophthalmologist or strabismus specialist for the AcSP.  Atropine, bifocals, biofeedback are all helpful.

JCH MD
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2 Comments
Atropine does help, however i only use it as needed not daily, with the severe migraines I have the atropine was making it unbearable to the point I didn't want to leave the house. I'm currently getting botox my last injection was in April and it worked great. But since I've had a few more spasms in different parts of the face/head and my jaw has been numb for about 2 months now, I see neurologist next week Finnaly.

Is there any particular nerve, or part of the brain that could be causing this? And can it really get worse over time, I'm only 25 and haven't been able to work in almost 3 years now. And this is just a start to the many other problems I got.
Usually gets better over time as the focus muscle weakens as we age. The nerve involved is the 3rd cranail nerve Oculomotor. The cause is unknown.
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177275 tn?1511755244
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