Eyelid Twitching: Reason For Concern?
Last week, a patient visited me quite concerned about a problem that had recently developed. Her right eyelid had begun twitching uncontrollably; the problem was getting worse and people were beginning to notice. Before I was finished with my exam, she couldn't contain her anxiety: "Do I have multiple sclerosis?" Thankfully, she didn't have MS, but rather a much more benign issue known as blepharospasm (blef-er-o-spaz-m) - a twitching of the eyelid that cannot be controlled. The condition often raises a lot of questions, so here's a quick primer.
Eyelid out of Control
Blepharospasm usually comes unexpectedly with no specific cause, but it's believed that the most common contributing factor is stress. Caffeine, alcohol, sleep deprivation, and tobacco use are the other most commonly reported causes of blepharospasm.
This twitching often waxes and wanes in severity, and most patients state that the most annoying feature of the problem is that other people make note of it, creating more anxiety about the problem - a "catch 22."
The duration of blepharospasm can vary from days to months. By its nature, it comes on without warning and usually leaves the same way, but addressing any possible causes or associated factors early on can bring about a more swift resolution.
There are no underlying neurological diseases for which blepharospasm is a herald. Many people come in to see me quite sure they have multiple sclerosis, Parkinson's disease, or a brain tumor. No scan or further workup is needed, as long as the eyelid twitching is the only symptom present.
Most often the problem goes away on its own as quietly as it came on, with no therapy needed. For severe cases, botox has been used with some degree of success.
Reasons for Concern
Blepharospasm associated with other factors should be addressed by a doctor. Examples include changes in vision, headache, eyelid swelling, eye pain, numbness, tingling, or weakness.
Eyelid twitching, or blepharospasm, is a common and harmless condition. When present without any other symptoms, there is no reason for concern, and it should resolve spontaneously. To expedite this process, address stressors and practice moderation.