Skip to content

An Eyelid Twitch Is Probably More Than Just An Inconvenience

31 marzo, 2024

A eyelid twitch It is when the eyelid muscles suffer involuntary and repetitive spasms. Since an eyelid twitch is usually painless, people often overlook this condition and leave it undiagnosed. However, one eyelid twitch It can be uncomfortable and cause irritation. When experiencing severe spasms, immediate medical attention should be sought, which will allow for accurate diagnosis and effective treatment in a timely manner.

Know An Eyelid Contraction

An eyelid twitch is a repetitive spasm and involuntary release of the orbicularis oculi muscle, an eyelid muscle that is responsible for closing the eyelids. A twitch usually occurs in the upper eyelid, but can affect both the upper and lower eyelids. Eye twitching varies widely from barely noticeable to severe. When eye twitching exhibits along with an involuntary spasm of the facial muscles, it may be a warning sign indicating certain conditions that require urgent medical assistance.

Causes of Eye Twitching

Eye twitches have different causes, including:

  • Myoquimia palpebral : described as continuous, fine contractions that mainly affect the lower eyelid.
  • Blepharospasm : a condition characterized by abnormal blinking or twitching of the eyelids, which is usually a bilateral condition.
  • Hemifacial spasm : neuromuscular disorder characterized by frequent involuntary contractions of the muscles on one side of the face.
Eyelid twitching  It might not just be a nuisance.

Myoquimia Palpebral

Eyelid myokymia It is described as continuous, fine contractions that only affect the eyelid. This type of contraction is considerably common and happens to many people. Eyelid myokymia is usually unilateral and mainly affects the lower eyelid. It appears spontaneously and can last a few seconds, minutes, hours or even weeks.

Triggering factors of eyelid myokymia

Although the exact cause of eyelid myokymia is unknown, eyelid myokymia can be triggered by:

  • Fatigue or being too tired
  • Stress
  • Anxiety
  • excess caffeine
  • alcohol consumption
  • Exercise
  • From smoking
  • Irritation of the surface of the eye or inner eyelids.
  • Bright light
  • Wind or air pollution
  • Certain medicines, for example, topiramate, clozapine, gold salts (sodium aurothiomalate), and flunarizine

In addition, some neurological diseases, for example, demyelinating diseases, autoimmune diseases and brain stem pathology, can cause twitching of the eyelids, which are often accompanied by other neurological manifestations.

When to seek medical attention

As a self-limiting condition, eye twitches usually disappear within a few days after avoiding triggers. Make an appointment with an ophthalmologist if:

  • Contraction persists for more than 2-3 weeks
  • The eyelid closes completely with each contraction and has difficulty opening the eye
  • Contractions occur in other parts of the face or body.
  • Red or swollen eye, eye discharge
  • Fallen eyelid

Treatment of eyelid myokymia

  • Most cases are self-limiting after the triggering factors are completely eliminated.
  • If eye twitches persist for more than 3 months with impaired quality of life, administering a botulinum toxin injection into the eyelid muscles is often considered to help paralyze the twitching muscle.
Eyelid twitching  It might not just be a nuisance.


BlepharospasmIt is caused by an abnormal contraction of the eyelid muscles, causing involuntary blinking or twitching of the eyelids. It is usually a bilateral condition, affecting both eyes. Women, especially those between 40 and 60 years old, are more likely than men to have blepharospasm. The symptom may be mild at first. However, the frequency of muscle contractions and spasms may increase, causing an involuntary narrowing of the opening or closing of the eyelids. If it becomes progressive, it can potentially alter vision.

Causes of blepharospasm

The cause of blepharospasm is unknown , although there are likely genetic implications. In some cases, dopamine deficiency in the basal ganglia responsible mainly for motor control could play a fundamental role in the development of blepharospasm.

Triggers of blepharospasm

Blepharospasm is often induced by the following factors:

  • Previous head and facial trauma
  • Family history of movement disorders, for example, dystonia and tremor.
  • Reflex blepharospasm due to certain eye conditions, for example dry eyes, blepharitis (an inflammation along the edges of the eyelids), intraocular inflammation, and sensitivity to light.
  • meningeal irritation
  • Stress
  • Certain medicines, for example some antiparkinsonian medicines
  • From smoking
  • Movement disorders, for example, tardive dyskinesia, generalized dystonia, Wilson’s disease and parkinsonian syndromes.

Treatment of blepharospasm

  • Eliminate factors that contribute to reflex blepharospasm, including the use of artificial tear drops, treatment of blepharitis, and use of sunglasses, particularly FL-41 glasses to filter specific light wavelengths and prevent sensitivity to the light.
  • Taking oral muscle relaxants or hypnotic drugs.
  • Botulinum toxin injection into the eyelid muscle.
  • Surgical removal of the eyelid and eyebrow contracting muscles may be considered in patients who have not responded to serial botulinum toxin injections.
Eyelid twitching  It might not just be a nuisance.

Hemifacial Spasm

Hemifacial spasm is a neuromuscular disorder characterized by frequent involuntary contractions or spasms of the muscles on one side of the face. Although this condition occurs in both men and women, it most frequently affects women between 50 and 60 years old. In the initial stage, the first symptom of a hemifacial spasm is involuntary twitching on only one side of the face. Muscle spasms often begin in the eyelid as mild twitches that may not be noticeable. Over time, the contractions become more pronounced and spread to other areas on the same side of the face, such as the cheeks and lips. In severe cases, as the condition worsens, involuntary muscle spasms may be uncontrollably persistent. Hemifacial spasm rarely involves both sides of the face, however, the muscles on each side involuntarily contract at an unrelated time.

Triggers of hemifacial spasm

Involuntary muscle contractions in the face are often triggered by a variety of factors, such as:

  • facial movements
  • Anxiety
  • Stress
  • be too tired

Types of hemifacial spasm

Categorized by its etiology, hemifacial spasm can be divided into 2 main types:

  1. Primary hemifacial spasm: Primary hemifacial spasm is attributed to vascular loops that compress the 7th nerve cranial in its exit area of ​​the brainstem. Neurovascular compression when a blood vessel presses on the facial nerve leads to abnormal control of the facial muscles, causing involuntary contractions or spasms of the eyelid and facial muscles.
  2. Secondary hemifacial spasm: Secondary hemifacial spasm is less common than primary hemifacial spasm. Although the causes are unknown, it tends to run in the family. Potential risk factors are:
  • atherosclerosis
  • Arteriovenous malformations
  • aneurysms
  • Parotid gland tumors
  • Cerebellar pontine angle (CPA) tumor
  • 7th injury nerve cranial
  • Certain diseases related to the brain stem, for example stroke, multiple sclerosis, and Bell’s palsy.

Diagnosis of hemifacial spasm

  • Medical history and physical examination
  • Imaging tests, such as magnetic resonance imaging (MRI)

Treatment of hemifacial spasm

  • Some patients may respond to certain oral antiepileptic medications that are used to prevent muscles from contracting.
  • Botulinum toxin injection.
  • A surgical approach, called microvascular decompression, may be performed to relieve vascular compression of the 7th par cranial.

Most eyelid twitches go away without treatment within a few days. However, if the contractions become progressive and persistent for up to weeks or months disrupting daily tasks, medical assistance from an ophthalmologist should be provided without delay.