The old twitching eyelid

If you want to feel smart, just say you’re having fasciculations—it sounds more serious. It’s an odd phenomenon: out of nowhere, your eyelid starts twitching. You didn’t see it coming, you can’t stop it, you don’t know what caused it, and above all, it kind of bugs you. It’s usually completely harmless, but that doesn’t make it any less annoying. So can you avoid it?

Eye health | Stress and sleep

asktheexpert
Sonia Chartier
@AVogel_ca


23 April 2018

It’s one thing if your eyelid starts twitching, but it’s quite another if your eye winks when you weren’t trying to, especially if it lasts more than a few seconds. If it does, we’re no longer talking about fasciculations.

There are three kinds of involuntary muscle contractions that affect the eyelids.

The first, known as a “fasciculation,” is an involuntary contraction of the eyelid muscles. This is when an eyelid twitches at random, independently of the other eyelids, for a few minutes. Usually but not always, it’s the upper eyelid that twitches. It can affect both eyes, but not at the same time. Never painful and perfectly harmless, this kind of muscular twitching can be linked to stress, fatigue or caffeine, and it can turn applying mascara into a messy ordeal.

The second kind of involuntary muscle contraction is when both eyes blink too often or a wink lasts too long—in either of these cases, go see a doctor. This more serious type of spasm might be caused by an underlying condition: inflammation or irritation of the eyelid or the cornea, dry eye, glaucoma or light sensitivity. In very rare cases, the eye spasm is the result of a nerve disease like multiple sclerosis, Tourette’s syndrome, Bell’s palsy or cervical dystonia. All of these conditions also have other symptoms.

The third type of involuntary muscular contraction is particularly problematic. If you find yourself unable to open your eyes for hours, days or even weeks, you might be experiencing a benign essential blepharospasm, which is described as a forced, involuntary and sustained closure of one or both eyes. Though still unexplained, this type of muscular spasm isn’t dangerous. However, it does seriously impact quality of life: as long as you’re unable to open both eyes, you’re effectively blind. This type of spasm might be caused by fatigue, stress or an environment that your eyes find irritating, such as one involving bright light, air pollution or wind.

Other muscle contractions and nervous tics

Involuntary muscle contractions sometimes make muscles other than the eyelids twitch. But this shouldn’t be confused with a nervous tic. Whether motor (a sudden and brief motion) or vocal (a sound), nervous tics appear suddenly and repetitively within an otherwise normal behaviour. This can include blinking repeatedly or constantly clearing your throat. These tics, known as “unvoluntary” movements, are neither voluntary or physically involuntary: if you try really hard to refrain from doing them, you can usually control them. It would appear that stress and lack of sleep play a role in the appearance and intensity of tics.

Nervous tics generally first appear in children and can be divided into two types: transitory and chronic. Transitory tics affect 5% to 25% of school-aged children, especially boys. They’re often only temporary, affecting children for anywhere from a few weeks to a few months. If the tic or tics last longer than that, they are considered chronic. Less than 1% of children are affected by chronic tics.

Fasciculation triggers

The muscle contractions we mentioned above, those that make your left eyelid twitch, are not nervous tics. They are totally involuntary and uncontrollable and amount to isolated, non-repetitive events. Sure, your eyelid twitches more than once, but after a couple of minutes, the twitching stops on its own. Given that the phenomenon is perfectly harmless, no one is offering researchers any money to study it.

The actual cause of these eyelid acrobatics remains unknown, but certain triggers have been identified:

Lifestyle factors

  • Alcohol consumption
  • Too much caffeine
  • Cigarette smoke (irritant)
  • Drug use

Environmental factors

  • Bright light (especially when you’re tired)
  • Wind (irritates the eyes)

Physical factors

  • Irritation of the eyes or the inside of the eyelid
  • Lack of sleep
  • Physical strain
  • Stress
  • Lack of magnesium
  • Certain medications (for epilepsy or psychosis)

Things that trigger involuntary muscle contractions and nervous tics

Such involuntary twitching sometimes affects other muscles. A finger or even an entire leg can sometimes start wiggling on its own. In these cases, the possible triggers are similar but fewer:

  • Stress: the body reacts to stress by sending an unusual shot of hormones or a surge of blood to the muscles. Twitching can even be a reaction to these changes.
  • Adrenaline: closely linked to stress, a shot of adrenaline can provide muscles with a sudden energy boost and an urgent need to move.
  • A lack of magnesium: because stress drains our magnesium store and a lack of this mineral is involved in twitches, it makes sense that the two factors should be closely linked.
  • Anxiety. Even though anxiety is a manifestation of stress, I’m separating the two because if you’re anxious, you might worry about the twitches, which are sometimes (though rarely) linked to serious illnesses—you’ll agree that a shaking leg is more worrying than a twitching eyelid.

Preventing involuntary muscle contractions and fasciculations

To prevent twitching, you can:

  • Cut down on coffee: If you’re a big coffee drinker, go easy! Start by replacing your third or fourth cup of the day with a coffee substitute or herbal tea.
  • Cut down on your alcohol intake.
  • Exercising turns out to be an excellent way to lessen the impact of stress on your body. However, very intense physical activity can lead to twitching when muscles become exhausted.
  • Adopt a diet that will help you manage stress, one well balanced and rich in vitamins and minerals. 
  • Ideally, avoid too much stress! While some level of stress is inevitable and even healthy, more relaxing activities are always beneficial. For example, watch a fascinating documentary on the intimate lives of goldfish instead of a thrilling action movie. Okay, so maybe I’m exaggerating a bit, but you get my point.
    When lack of sleep and stress are contributing factors, consider passion flower. This plant is a nerve tonic that helps you relax and sleep better during stressful periods, and it can also be used to treat restlessness and agitation.

So, if your eye twitches a little too often for your taste, you know what to try. But if your eyelid twitches every once in a blue moon, don’t worry: your eyebrow won’t be any worse for the wear. If anything, you can use the occasional twitch to show off your impressive vocabulary by talking about fasciculations.

References:
https://www.webmd.com/eye-health/why-your-eyes-twitch#1
https://www.passeportsante.net/fr/Maux/Symptomes/Fiche.aspx?doc=paupieres-tremblent-symptome
https://www.mayoclinic.org/symptoms/eye-twitching/basics/causes/sym-20050838
http://www.blepharospasm.ca/fr/index.html
https://www.webmd.com/brain/tic-disorders-and_twitches#1
https://www.calmclinic.com/anxiety/signs/muscle-twitching

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