Mr. A was a 43-year-old, single Caucasian male who became psychiatrically ill at age 22 years and had since been taking various neuroleptics. From 1980 to 1996, he was prescribed thioridazine, 50 mg/day. More recently, his thioridazine therapy was changed to treatment with risperidone, 6 mg/day, as a result of an exacerbation of his symptoms. Mr. A then started blinking frequently. Sometime later, he noted episodic blepharospasms that either occurred spontaneously or were triggered by stress. As a result, he had to discontinue vision-dependent activities such as driving. More recently, he sought help for blepharospasms.
During an interview, Mr. A was noted to have intermittent blepharospasms that affected his vision. The more he tried to open his eyes, the more tightly his eyelids closed. He often struggled for about 3–5 minutes to open his eyes.