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Question:
What might be the cause of upper eyelid twitching (myokymia) lasting on and off over several months? How might it be treated?

Answer:
Eyelid spasms, twitching, or "myokymia" are annoying but not dangerous. Lack of sleep, stress, caffeine, etc., may contribute to these spasms. If the spasm is distracting, a treatment with Botox may adequately treat the symptoms. If the twitching descends into the lower face, the individual may have hemifacial spasm. In this condition, an abnormal vascular loop may pulse against the seventh nerve, causing the facial spasm. Hemifacial spasm may be treated with Botox as well. Hemi-facial spasm may also represent a tumor, and therefore an MRI to look for a tortuous vessel or mass abutting the seventh nerve is suggested in the evaluation of hemifacial spasm. An ophthalmologist can diagnose and recommend appropriate treatment for myokymia.

Answered by: Rona Silkiss, MD Dr. Rona Silkiss

Categories: Eye Conditions

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Answered: Oct 30, 2013

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