Myokymia

myokymia or orbicularis oculi myokymia is benign eyelid twitching. it is most frequently caused by high stress, lack of sleep or too much caffeine. the recommended treatments are: more sleep, less stress, less caffeine. warm compresses usually stop it temporarily as well. it has also been noted anecdotally that topical (eyedrop) antihistamines may help (off label usage). some good ones to try 1st are inexpensive OTC eye drops like Bausch & Lomb "Alaway" or Novartis "Zaditor", which are both ketoifen fumarate. there are multiple generic versions with the same active ingredient.

sometimes some vitamin deficiencies can play a role, so a multivitamin can help.

myokymia is really common. people ask about it on yahoo answers nearly daily. there is some really bad info out there on this subject and i have to "thumbs-down" bad answers on it all the time.

myokymia is not the same as "blepharospam". blepharospasm is facial cranial nerve damage & needs a neurological workup. blepharospasm is CONSTANT. so the easiest way to tell if you have totally benign myokymia vs more serious blepharospasm is:

if it is constant, 24/7, never ever stops...could be blepharospasm
if it comes & goes, its myokymia

also, myokymia only involves the upper or lower eyelids. if its your EYELID thats twitching, its myokymia. blepharospasm almost always involves multiple facial muscles like the muscles that help you "squinch" your eyes together tightly or wink. if its ONLY your eyelid, its myokymia not blepharospasm.

and finally, blepharospasm can be seen by others when they look at you, myokymia almost can never be seen by others. so if you feel it but no one else can see it twitch, then its myokymia.

Wile E. Coyote experiences myokmia. have you seen this on the old Roadrunner cartoons? the roadrunner does something that irritates the coyote & Wile E. Coyote looks at the camera & his facial muscles twitch. this is confusion on the part of the animators...as myokymia is not seen from the outside. I guess thats the only way they can portray that stress, tho.

i am currently sufferring from myokymia myself. i know what my cause is: lack of sleep. i wake up in the morning and i dont twitch...but later in the day it starts. i know i need more sleep & less caffeine but its difficult with work & family. this happens to me a few weeks a year so i'm used to it. no biggie: i usually use topical Bepreve (Rx antihistamine eye drop) b/c we have in-office samples. a warm compress is not really feasible at work.

Comments

  1. recently another doc suggested to me that TONIC WATER could help with this. interesting & worth a try. makes sense, since tonic water is commonly recommended for people who have nocturnal leg cramps (which i ALSO HAVE and had last night!). maybe i just need more potassium too!

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  2. to clarify...DRINKING tonic water. not for instillation in the eye

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  3. Just doing a search on this as my right eyelid has been twitching for a week and I was beginning to think I had a brain tumor! Thanks for the good info. I will try ALL your remedies.

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  4. Thanks I was thinking I had some sort of worm in my eye... Because I had this feeling of twitching in my eye... It started during my exams I hadn't slept for three days and extreme computer usage.

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  5. i drink coffee a lot, but the twitching starts when i stop drinking it, could it be some sort of withdrawal or s/thing? btw, thanks for the info..

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  6. Replies
    1. Thank you for your excellent information. It allayed my fears.

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  7. Thank you so much for your information! This has put my mind at ease! I need some sleep and some stress relief!

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  8. THANK YOU FOR YOUR INFORMANTION. I WAS WONDERING THOUGH IF MYOKYMIA CAN INVOLVE BOTH UPPER EYELIDS AT THE SAME TIME? I HAVE HAD ON AND OFF UPPER EYELID TWITCHES FOR 2 MONTHS.

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  9. Thank you for taking the time to reply. I have been very worried since the twitching is in both upper lids. Weird thing is though that they are generally triggered by me sneezing, yawning, rubbing my eyes, or blinking hard. Is this normal??? I did have some botox injections done in my forehead and around my eyes one week before the twitching started. Could this be a side effect? I know its used to treat spasms.

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  10. Normal? Probably not normal. But also IMO not alarming

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  11. Really feel annoying since the upper eyelid twitching happened since TWO months now. Sometimes even when I woke up in the morning, it started!! Just checked by optical doc with cycloplegics and suffered half day "cumputer blind". No help at all. Have to try your solutions...

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  12. I have myokymia of both upper eyelids and it is difficult for others to see unless I am having a spasm event and can tell them to watch for it - even then, the spasms are so quick they are hard to catch. Have them in other locations, mostly larger muscles like thighs and trapezius. Have filmed them (thighs and eyes) with camera, and is still a quick spasm to catch, but was able to show eye-doc to get the diagnosis. Mine usually affects the outer sides of my eyes,and mine is triggered by low magnesium, and sometimes low manganese; low potassium generally does not cause spasms, unless one has a channelopathy with myoclonus. I usually drink organic coconut water (high in manganese, pop a 200mg Magnesium Citrate and take 500mg Vitamin C (to aid in absorption of the magnesium and manganese) to end the spasm event, covering both bases. Magnesium and manganese insufficiency/deficiency trigger seizures (non-epileptic), although not all of these seizures are tonic-clonic in manifestation as is how the word is defined by the general public. My spasms can be mild, as in the myokymia, or can look epileptic in nature depending on the severity of my deficiency. Have been taking 10-11oz. coconut water, and 200mg MagCit twice daily (with VitC of course) since June last year (2014); myokymia rarely manifested after the first 3-mos. on this regimen, and too significant decrease in nighttime leg cramps and thigh myokymia. FYI, UCLA published a paper on magnesium:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062555/
    Thanks for the article on myokymia, Lizela.

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  13. I have been getting eyelid twitching on and off for the last 5 months. It started with the lower left eyelid near the lash line and happened every few minutes for a couple of seconds for three months. It subsided and then reappears after a few days or 2-3 weeks. My right lower lid also spasms on the lower lid above the cheek bone occasionally. When I squeeze my eyes shut I will get a spasm in both lids for a couple of seconds, Is this mykomia or blepharospasm. It is not constant but seems to go from one eye to the other.

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  14. if it is not constant it is almost certainly myokymia. blepharospasm is from facial cranial nerve damage and is constant

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  15. Thank you so much for replying so quickly. Can this type of twitching go on indefinitely? When you mentioned squinch your eyes tightly and winking what muscles are you referring to. My lower right eyelid above the cheek will spasm for a couple of seconds when I squinch my eye closed tightly voluntarily. Thank you again for your reply

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  16. yes it "can" go on indefinitely, but it almost never does. it usually lasts a few weeks or maybe months then goes away

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  17. Thank You for all the information, I really appreciate it.

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  18. I just have been diagnosed with myasthenia gravis, dicovered by drooping eyelids. Simultaneously I had noticed for a few months what you describe as myokymia (intermittent twitch), which now under pyridostigmine treatment appears to get worse 2-4 hours after taking it.
    Since I'm at the beginning of MG treatment I just wanted to report the symptoms, without fishing for a diagnosis at this point. I'll report more when I know more. Thanks for the info in this blog.

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  19. Hi,
    I have had chronic intermittent under eyelid spasm near the lower eye lash on the left eyelid for almost 7 months, it is not constant but happens through out the day. It is less frequent but still there. Any time I touch the eyelid, sneeze, or rub the right eye the left lower eyelid spasms for about 30 seconds. On occasion the upper lid or the other eyelid will twitch. I went for an eye exam 1 month after this started and was told it is myokymia, my eyes are healthy. I do have dry eyes, floaters, some allergies,and wear glasses. I use restasis twice a day and moisturizing drops throughout the day. My concern is that I still have this going on all this time, it did stop for a couple of weeks but came back. Could this be something other than myokymia because it's lasting so long. After reading many articles on this, it is described as a benign condition and is only a concern if other muscles in the face are affected. I have tried everything without success, tonic water, vitamins, less caffeine,etc. nothing works. This causing me anxiety. Can this last forever or will it stop eventually?
    Thank You

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    1. while that is very, very annoying on your end...it is still not concerning. no, it will not last forever. I have this myself every few months so I know how irritating it can be, and yet it is still a benign condition and is never permanent and is not concerning at all. just annoying. more sleep, less stress, less caffeine...that's about the best you can do, probably. good luck! it is not permanent. it will eventually go away. 7mo is a long time, but you will not be stuck forever

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    2. Thank you for your reply. I truly appreciate it.

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  20. Can myokymia affect both eyelids? Everything I've read says emphatically "one" eye only, but twitching occurs in both eyes (although more often in left). I've had it sporadically for the past 6 weeks and was told it was most likely benign.

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  21. although both eyelids would be rare, it's certainly not impossible. any eyelid twitching that is not constant (i.e. "comes and goes") is almost certainly benign

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  22. I have been diagnosed with eyelid myokymia. Have had it for 2 and a half months now.. VERY FRUSTRATING. I have good days and very bad days. Today is a bad day. I am trying to avoid botox. I am wondering about the use of antihistamines to treat myokymia. Don't antihistamines cause your eyes to dry and isn't dry eyes a cause for myokymia. I haven't used antihistamines because I don't think my eyelid spasms are because if allergies but if they have been proven to work I will try it.. Thank you

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    1. "Don't antihistamines cause your eyes to dry and isn't dry eyes a cause for myokymia."

      I personally do not believe this, no. But "dry eye" is listed by some as a possible cause.

      "I haven't used antihistamines because I don't think my eyelid spasms are because if allergies but if they have been proven to work I will try it"

      antihistamine use for myokymia is an off-label suggestion. in other words...I don't think your myokymia is caused by allergies, either. that doesn't mean antihistamines won't work.

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  23. I have been diagnosed with eyelid myokymia and have had it for 2 and a half months. I have good days and bad days... Today is a really bad day. I have tried everything to get rid of them except the antihistamines. I thought antihistamines dry the eyes and isn't dry eyes a trigger for myokemia?
    Will try the antihistamines if they will help. I think my next step is botox.
    Thanks

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  24. Sorry for the double entry. I didn't think the first entry went through. So I wrote up a second. I will try anantihistamine. Why not, I have tried everything else. Thank you for taking the time to reply.

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  25. I have been suffering with eyelid twitching for the last 18 months, it is not constant but chronic. I have dry eyes and use restastis, I also have large floaters, and suffer with sinuses. The twitching stopped for about 3 months but has now returned daily for the last 5 weeks. Both eyelids twitch upper,lower and mostly lower left eye. Can eyelid myokymia be a a chronic condition? I have tried every remedy and nothing seems to work. Is this always a benign condition, its driving me crazy. Do you have any suggestions? Thank You

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    1. HI Guys, oh thank goodness I found this site! I've had an eye twitch for 5 months now, started out really bad and it now mainly twitches when I touch it, sneeze, my hair gets in it or I put in eye drops, it will go nuts and then stop. I'm so happy to hear that others have this too! I thought that maybe it's the start of a hemifacial spasm as sometimes I feel like my mouth is twitching too but I think that's just stress and I'm always 'holding' a grumpy face due to the twitch. I, too, have tired everything, tonic water, magnesium, fish oil pills, more sleep - less stress but it's still here! I suffer from anxiety as well so that doesn't help. I'm back to my neurologist today - last time he said mykomia but I've still got it and my left eye is twitching too though you can't see it I can feel it, my right eye is the main twitcher. It's so frustrating isn't it!! I'm sorry I see that this post is nearly a year old but I'm going to post this anyway!

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    2. I have been suffering with eyelid twitching for 2 years . When it first started I did go for an eye exam and was told it was eyelid mykomia. I can feel it but it can't be seen unless you point it out. I never thought this would be happening 2 years later. I also feel like my lip or cheek may twitch, but it isn't when I look in the mirror (convince myself it's the start of hemifacial spasm ) I have tried every remedy but nothing works. Personally I think anxiety is the main culprit. I'm curious what your neurologist recommends, most doctors are not concerned about twitching unless other issues are also happening.

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  26. BOTOX. yes, botox injections. go see a neuro-ophthalmologist

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