section name header

Information

Editors

SariAtula

Eyelid Myokymia

Essentials

  • Benign, self-limited muscle contractions usually involving the orbicularis oculi muscle in the area of the lower eyelid
  • There is no exact information on prevalence; usually occurs in young, otherwise healthy people.
  • Not associated with neurological diseases, provided that there are no other symptoms
  • Additional investigations are not indicated if myokymia only involves one muscle.

Symptoms and predisposing factors

  • Fine, continuous involuntary muscle contractions, which progress to involve the entire muscle
    • An EMG study shows spontaneous, rhythmic or semirhythmic unsynchronised bursts of a single motor unit.
  • Usually affects the lower eyelid unilaterally, but may occur in other small facial muscles as well.
    • May occur in other voluntary muscles of the limbs and, more rarely, the trunk.
  • One episode usually lasts continuously for no longer than a few hours.
  • Symptoms usually disappear after a few days and do not progress to involve other muscles.
  • In healthy individuals predisposing factors often include tiredness, stress, physical exertion or excessive caffeine intake.
    • Alcohol and smoking may also provoke episodes.

Investigations and treatment

  • No further investigations are indicated, provided that myokymia does not progress to involve other muscles (very rare).
  • An explanation of the benign nature of the condition and exploration of lifestyle-associated predisposing factors are usually the only treatment needed.
  • Magnesium is sometimes used as treatment for myokymia, although there is no actual research evidence on its effectiveness.
  • If the symptoms persist for several months and cause the patient discomfort, botulinum injections may be used.
    • Symptoms have been known to disappear completely after just one injection, but in some cases repeated treatments may be required.

    References

    • Miller NR. Eyelid myokymia. Surv Ophthalmol 2011;56(3):277-8; author reply 278. [PubMed]
    • Jafer Chardoub AA, Patel BC. Eyelid Myokymia 2021;():. [PubMed]