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Eyelid twitching is also called eyelid myokymia, and it is one of the most common disorders of eyelid muscle innervation. This condition usually temporary, and it can affect persons from all age groups and both genders. However, there are some cases in which a prolonged episode of myokymia may be a sign of a more serious neurological disorder. Here are some of the key features of eyelid myokymia, including presentation, possible causes, and information about when to see your doctor.

Symptoms Of Eyelid Myokymia

Eyelid myokymia is usually reported as involuntary subtle twitching of one of the eyelids. The contractions are not strong enough to cause actual blinking, but they can sometimes be noticeable by another person. On the other hand, the person experiencing the twitching may have the impression that it is very noticeable because the feeling caused by involuntary muscle contraction can be very unpleasant. Eyelid myokymia affects the lower lid more commonly than the upper lid, and it usually affects only one eye. It can last from several minutes to several days.

Pathophysiology Of Eyelid Myokymia

We can safely say that almost everyone has experienced eyelid twitching at least once, and more probably multiple times during their lifetime. The exact pathophysiology of this benign condition is not yet fully uncovered, but we know that it is characterized by partial fascicular contractions of the Orbicularis oculi muscle. The twitches are very brief, but the intervals can be of different and irregular lengths. Although the exact cause of eyelid myokymia is unknown, there are some factors which have been confirmed to trigger its occurrence. Some of them include excess caffeine intake, stress, fatigue, and a lack of sleep.

Can Eyelid Myokymia Be A Sign Of A More Severe Disorder?

As we said before, eyelid myokymia is a benign condition which resolves on its own. In some persons, this condition can become chronic, but even then, it does not show a tendency to progress to a more severe neurological disorder. However, there have been case reports in which chronic eyelid myokymia progressed over time and after the twitching affected other facial muscles, the MRI showed signs of multiple sclerosis. These scenarios are very rare, but not impossible.

When Should You See Your Doctor?

If you notice occasional eyelid twitching after drinking a lot of coffee or being exhausted, like most people, it means that you have temporary, benign eyelid myokymia which will resolve on its own. You can speed up the recovery by eliminating the triggering factors (for example – have a good night sleep). If the symptoms become persistent and if they start to interfere with your daily activities, you may consider visiting your doctor to report the issue and get recommendations on how to resolve it. In cases of chronic eyelid myokymia, the symptoms are very successfully managed by botulinum toxin injections (Botox). If your eyelid myokymia gets worse over time, and if you get additional symptoms, you should definitely visit your doctor in order to have a detailed investigation carried out, which usually includes an MRI of the brain.

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