Information
Editors
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
- Jafer Chardoub AA, Patel BC. Eyelid Myokymia. 2025;(): [PubMed]