Twitching

Question 1

Eyelid Myokymia

• What is it
• Cause

Answer 1

Subtle eyelid twitch due to spontaneous contracture of the orbicularis muscle.

Unknown cause. Triggered by stress, caffeine, alcohol, ocular irritation, lack of sleep.

Question 2

Eyelid Myokymia
Demographics
Laterality

Answer 2

No predilection

Unilateral !!!!!!!!

Question 3

Eyelid Myokymia

Management

Answer 3

Self limiting
Modify/avoid triggers.
5-6 Oz tonic water. Contains quinine which may inhibit nerve impulses.

Question 4

How to differentiate Eyelid Myokymia from hemifacial spasm.

Answer 4

Hemifacial spasm is unilateral contracture of the entire side of the face, requires MRI to rule out tumor.

Question 5

Blepharospasm

• What is it
• Cause

Answer 5

Spastic, sudden involuntary muscular contraction. Twitching, blinking, or closure of the eyelids due to contraction of the orbicularis muscle.

Unknown cause. Associated with Meige’s syndrome

Question 6

Blepharospasm
Demographics
Laterality

Answer 6

Women >

Bilateral !!!

Question 7

Blepharospasm

Symptoms

Answer 7

Increased blink rate initially
Spasmodic eyelid closure as it progresses- disappears during sleep.

Interference with ADLs- may be functionally blind.

Ocular redness, irritation, tearing.

Question 8

Blepharospasm signs

Answer 8

Spastic twitching, blinking, closure of the eyelids.
Conj injection
SPK

Question 9

Blepharospasm management

Answer 9

Refer out for botox or surgery,

supportive management for SPK

Question 10

Blepharospasm associated with what syndrome

Answer 10

Meige’s

-Characterized by dystonia (movement disorder in which a persons muscle contract uncontrollably. Jaw, tongue, eyelids)