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Question answered:14/01/08 Warning! this question is over two years old.
eMedicine (an online American medical textbook) has a section on eyelid myokymia [1] which states:
“The cause [of eyelid myokymia] is unknown but may be associated with stress, fatigue, and excessive caffeine or alcohol intake.”
It also cautions:
“If the eyelid myokymia is associated with contraction of other parts of the face, blepharospasm, Meige syndrome, hemifacial spasm, and spastic-paretic facial contracture should be excluded.”
eMedicine provides information on treatment of eyelid myokymia as follows:
"Reassurance and reduction in precipitating factors, if identifiable, are appropriate for most patients.
Treatment is usually not needed except when symptoms are severe or when oscillopsia is present.
- Local subcutaneous botulinum toxin A (BOTOX®) injections of 2.5-5 units each to the affected eyelid region provide relief for 12-16 weeks. If the upper eyelid is involved, the injections should not be placed near the levator palpebrae; otherwise, ptosis lasting weeks will result. [Further information available on eMedicine site via the link below]
- Adverse effects include temporary lid laxity, which may produce lagophthalmus, exposure keratopathy, and ptosis.
- The efficacy of other agents has not been proven.
Note that persistent myokymia followed by spastic paretic facial contracture is an important (although uncommon) sign of disease in the dorsal pons, which may be seen in multiple sclerosis and brainstem neoplasms or vascular lesions.”
Medline Plus (aimed at patients) refers to the condition as blepharospasm [2] for which has a section on causes, reporting
“The most common things that make the muscle in your eyelid twitch are fatigue, stress, and caffeine. Once spasms begin, they may continue off and on for a few days. Then, they disappear. Most people experience this type of eyelid twitch on occasion and find it very annoying. In most cases, you won't even notice when the twitch has stopped.
More severe contractions, where the eyelid completely closes, are possible. These can be caused by irritation of the surface of the eye (cornea) or the membranes lining the eyelids (conjunctiva).
Sometimes, the reason your eyelid is twitching cannot be identified. This form of eyelid twitching lasts much longer, is often very uncomfortable, and can also cause your eyelids to close completely.”
Both the Merck Manual [3] and eMedicine [4] have chapters on blepharospasm.
References
1. http://www.emedicine.com/oph/topic607.htm
2. http://www.nlm.nih.gov/medlineplus/ency/article/000756.htm
3. http://www.merck.com/mmpe/sec09/ch100/ch100c.html
4. http://www.emedicine.com/oph/topic202.htm
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