What are the other Names for this Condition? (Also known as/Synonyms)

• Eyelid Myokymia
• Eyelid Twitching
• Ocular Myokymia

What is Myokymia? (Definition/Background Information)

• Myokymia is a condition in which the eyelid suddenly begins to twitch involuntarily. It usually affects one eye during each episode, and only involves the eyelid. Eyelid Twitching usually occurs multiple times during each episode
• Myokymia occurs when there is a misfiring of neurons supplying the orbicularis oculi muscle, which is the muscle that surrounds the eye and is responsible for closing the eye
• In more rare cases, Myokymia may also occur due to twitching of the superior oblique muscle, which is primarily responsible for rotating the eye inward
• The predisposing factors for Myokymia includes excess intake of coffee or alcohol, anxiety and stress, and a loss of sleep. In a vast majority of cases, no complications are noted
• The condition is typically benign and self-limiting. The treatment may involve addressing the underlying cause, if needed. The prognosis of Myokymia is usually excellent

Who gets Myokymia? (Age and Sex Distribution)

• Myokymia may occur at any age, however young adults are typically affected
• The condition can affect both males and females
• The exact prevalence of Myokymia is unknown, but the condition is reportedly very common
• It may be observed in individuals of all racial and ethnic groups

What are the Risk Factors for Myokymia? (Predisposing Factors)

The risk factors for developing Myokymia may include:

• Loss or lack of sleep
• Stress
• Fatigue
• Anxiety 
• Excessive caffeine intake such as by consuming too much of coffee or energy drinks
• Excessive alcohol intake
• Smoking 
• Dehydration
• Magnesium deficiency

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Myokymia? (Etiology)

• Myokymia is usually caused by the involuntary, fine contractions of the orbicularis oculi muscle, the muscle that surrounds the eye and is normally responsible for closing the eyelids
• The neurons that stimulate the orbicularis oculi muscle misfire, causing rapid intermittent stimulation of the muscle, leading to the muscle contractions and twitching of the eyelid

These events can be triggered by a variety of factors such as excessive caffeine or alcohol intake, stress, fatigue, and a lack of sleep.

What are the Signs and Symptoms of Myokymia?

The signs and symptoms of Myokymia may include:

• Uncontrolled twitching of the eyelid
• Discomfort
• If the superior oblique muscle is involved, then the following are observed:
  • Double vision
  • “Shaking” vision 
  • Tilted or rotated vision
• Myokymia usually affects the lower eyelid, but it can also affect the upper eyelid

How is Myokymia Diagnosed?

• Myokymia is usually diagnosed based on patient self-report of uncontrolled Eyelid Twitching
• It may also be diagnosed based on the observation of successive unilateral (one eye) Eyelid Twitching by the attending physician
• Obtaining a thorough patient history, including routine or excessive caffeine intake, alcohol consumption, stress, fatigue, or lack of sleep may aid in the diagnosis of Myokymia
• No other specific exams or tests are generally necessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Myokymia?

Myokymia is a benign and self-limiting condition in most cases, which does not typically lead to complications. However, in rare instances, it may be a precursor to the following conditions:

• Blepharospasm
• Meige syndrome
• Facial Myokymia
• Multiple sclerosis (MS)
• Hemifacial spasm

How is Myokymia Treated?

The treatment measures for Myokymia may include: (depending on the underlying cause)

• Avoiding or decreasing caffeine intake
• Avoiding or decreasing alcohol consumption
• Drinking tonic water
• Resting (getting adequate amounts of sleep)
• Keeping oneself hydrated
• Temporary use of allergy eye drops or pills
• Cool compresses to reduce any swelling associated with allergy
• Warm compresses to relax the involved eyelid muscle
• Botox injections for extreme cases that persist

How can Myokymia be Prevented?

The preventive methods for Myokymia may include:

• Getting plenty of sleep each night
• Avoiding or decreasing caffeine intake
• Avoiding or decreasing alcohol consumption
• Avoiding smoking
• Staying well hydrated
• Healthy lifestyle with good nutritious food, physical activity, and lowering stress levels

What is the Prognosis of Myokymia? (Outcomes/Resolutions)

The prognosis of Myokymia is typically excellent as it is a self-limiting condition.

• Myokymia almost always resolves on its own, even without treatment, generally within a few days to weeks
• The length of time for which Myokymia manifests varies, with some cases only lasting a few minutes, while other cases lasting even up to three weeks

Additional and Relevant Useful Information for Myokymia:

• Myokymia may be confused with blepharospasm, which is a separate (medical) condition characterized by sustained, involuntary spasms of the eyelids of both eyes
• Myokymia may feel very noticeable to the affected individual, but in some cases, may be difficult for others to actually perceive it