eMedicine Specialties > Ophthalmology > Lid

Eyelid Myokymia: Differential Diagnoses & Workup

Author: Byron L Lam, MD, Professor, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Contributor Information and Disclosures

Updated: Apr 14, 2009

Differential Diagnoses

Blepharospasm, Benign Essential

Other Problems to Be Considered

Hemifacial spasm - Unilateral facial contraction due to seventh nerve dysfunction

Meige syndrome - Blepharospasm and oral facial dystonia

Spastic-paretic facial contracture - Unilateral tonic facial contracture due to pontine dysfunction, associated usually with multiple sclerosis, and brainstem tumors or vascular lesions

Workup

Imaging Studies

  • Brain magnetic resonance imaging (MRI) is not needed for typical eyelid myokymia but should be considered if facial myokymia, hemifacial spasm, or spastic paretic facial contracture is suspected.

More on Eyelid Myokymia

Overview: Eyelid Myokymia
Differential Diagnoses & Workup: Eyelid Myokymia
Treatment & Medication: Eyelid Myokymia
Follow-up: Eyelid Myokymia
References
Further Reading

References

  1. Baldwin MR, Barbieri JT. Association of Botulinum neurotoxins with synaptic vesicle protein complexes. Toxicon. Apr 8 2009;[Medline].

  2. Brin MF. Basic and clinical aspects of BOTOX((R)). Toxicon. Mar 31 2009;[Medline].

  3. Pickett A. Dysport((R)): Pharmacological properties and factors that influence toxin action. Toxicon. Mar 28 2009;[Medline].

  4. Moe ST, Thompson AB, Smith GM, Fredenburg RA, Stein RL, Jacobson AR. Botulinum neurotoxin serotype A inhibitors: small-molecule mercaptoacetamide analogs. Bioorg Med Chem. Apr 15 2009;17(8):3072-9. [Medline].

  5. Capkova K, Salzameda NT, Janda KD. Investigations into small molecule non-peptidic inhibitors of the botulinum neurotoxins. Toxicon. Mar 25 2009;[Medline].

  6. Andermann F, et al. Facial myokymia in multiple sclerosis. Brain. 1961;8:31-44.

  7. Banik R, Miller NR. Chronic myokymia limited to the eyelid is a benign condition. J Neuroophthalmol. Dec 2004;24(4):290-2. [Medline].

  8. Givner I, Jaffe NS. Myokymia of the eyelids; a suggestion as to therapy; preliminary report. Am J Ophthalmol. Jan 1949;32(1):51-5. [Medline].

  9. Krohel GB, Rosenberg PN. Oscillopsia associated with eyelid myokymia. Am J Ophthalmol. Nov 15 1986;102(5):662-3. [Medline].

  10. Lowe R. Facial Twitching. Trans Ophthalmol Soc Aust. 1951;11:129-133.

  11. Reinecke RD. Translated myokymia of the lower eyelid causing uniocular vertical pseudonystagmus. Am J Ophthalmol. Jan 1973;75(1):150-1. [Medline].

  12. Rubin M, Root JD. Electrophysiologic investigation of benign eyelid twitching. Electromyogr Clin Neurophysiol. Sep 1991;31(6):377-81. [Medline].

  13. Scott AB. Botulinum toxin for blepharospasm. In: Spaeth G, Katz LJ, Parker KW, eds. Current Therapy in Ophthalmic Surgery. Toronto: Decker; 1989:322-324.

  14. Sogg RL, Hoyt WF, Boldrey E. Spastic paretic facial contracture. A rare sign of brain stem tumor. Neurology. Jul 1963;13:607-12. [Medline].

Keywords

eyelid myokymia, eyelid twitching, eyelid jumping, muscle contractions, blepharospasm, Meige syndrome, hemifacial spasm, spastic-paretic facial contracture, botulinum toxin A, BOTOX®, BOTOX® injections

Contributor Information and Disclosures

Author

Byron L Lam, MD, Professor, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Byron L Lam, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Ron W Pelton, MD, PhD, Private Practice, Colorado Springs, Colorado
Ron W Pelton, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Colorado Medical Society, Utah Medical Association, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark T Duffy, MD, PhD, Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic
Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience
Disclosure: Allergan - Botox Cosmetic Consulting fee Consulting; Quest medical - lacrimal balloons Honoraria Speaking and teaching; Ortho-Neutrogenia Consulting fee Consulting

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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