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Question answered:25/07/07 Warning! this question is over two years old.
We found relatively little on this topic, this is compounded by a lack of clear diagnosis. 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.”
If you would like further information on treatment options once a diagnosis is established, please let us know via the Contact Us link: http://www.clinicalanswers.nhs.uk/index.cfm?action=contact.
Reference
1. Eyelid Myokymia. eMedicine. [Last updated 1 November 2006]
http://www.emedicine.com/oph/topic607.htm
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