Which physical findings are characteristic of eyelid myokymia?

Updated: Oct 08, 2019
  • Author: Byron L Lam, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Fine fascicular nonsynchronous contractions of the orbicularis oculi may be visible if the patient has the contractions during examination. If present, the contractions are usually intermittent and are more apparently felt by the patient than visible to the observer. The symptoms often improve when the eyelid is pulled manually. Rarely, the contractions may be vigorous enough to cause movement of the globe, producing fine nystagmuslike eye movements.

If the eyelid myokymia is associated with contraction of other parts of the face, hemifacial spasm, blepharospasm, Meige syndrome, and spastic-paretic facial contracture should be excluded. Activation of the facial muscles (eg, big smile, eyelids squeezed shut) helps to determine if the eyelid myokymia is associated with contractions of other parts of the face.

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