Objective: We describe a case of a 31 year old lady with cluster headache associated with secondary unilateral spasm of left eyelid resulting in closure of the eye.

Background: Cluster headache is characterized by recurrent, severe headaches occurring unilaterally typically around the eye, supraorbital and temporal regions. This is associated with autonomic/ parasympathetic symptoms such as Lacrimation, rhinorrhea and conjunctival congestion. There are a few anecdotal case reports where it is associated with hemifacial spasms and unilateral blepharospasm.Here we report a case of cluster headache with secondary unilateral spasm of left eyelid resulting in closure of the eye, treated with Botulinum Toxin, with complete recovery

Method: 31 year old lady, presented with recent onset left sided cluster headache associated with closure of left eye. Visual Analogue Scale score – 8. This was also associated with lacrimation and redness of left eye. Patient had such 2 similar episodes in past 2 months. She was evaluated with MRI Brain(plain with contrast), MR Angiogram Brain, relevant blood investigations, which were normal. A detailed ophthalmology and psychiatric evaluation was normal. She was treated with injectable analgesics, Verapamil 120mg/day in divided doses, oral steroid and oxygen therapy.Headache partially improved but blepharospasm persisted. Botulinum toxin- 30units injected in the left orbicularis oculi to relieve the left eyelid spasm

Results: Left sided blepharospam improved 10 days after Botulinum injection, with almost complete recovery. Her medications for cluster headache were continued with improvement in VAS -2

Conclusion: Patients with Cluster headache associated with secondary blepharospasm not responding/ resistant to the conventional medications, can be treated with Botulinum Toxin, as in this case

References: 1) Bagheri A, Mohammadi M, Harooni G, Khosravifard K, Feizi M, Yazdani S. Cluster headache associated with secondary unilateral blepharospasm: A case report and review of the literature. Journal of ophthalmic & vision research. 2017 Apr;12(2):225. 2) Miller NR, Walsh FB, Hoyt WF, editors. Walsh and Hoyt’s clinical neuro-ophthalmology. Lippincott Williams & Wilkins; 2005.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/cluster-headache-associated-with-secondary-unilateral-blepharospasm-a-case-report/