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What is it?

This is a condition whereby the one experiences twitching on one eyelid or one side of the face. It usually begins with twitching of the lower eyelid on the affected side of the face, and may progress to involve the cheek and the corner of the mouth. 

What is the cause?

Most of the time, it is caused by an artery in the brain that is unusually situated close to the nerve root of the facial nerve (7th cranial nerve) and touches the facial nerve when it pulsates. It can also be caused by a brain tumour or nerve injury.

A magnetic resonance imaging (MRI) of the brain is needed to ensure that that is no unusual cause such as a brain tumour pressing on the facial nerve.

What is the treatment?

If the spasms are mild and very occasional, some people may choose to observe it.

For most cases though, the spasms may progressively cause involuntary closure of the eye on the affected side, and this may either be bothersome or be a form of social embarrassment. There are 2 treatment options:

  • Botox injections – these can be given to the upper and lower eyelids, as well as the side of the face. The effects of Botox will last about 3 to 4 months (sometimes longer) and so will need to be repeated. Most people opt for this treatment as it is a very safe procedure. 
  • Decompression surgery for the facial nerve – this is a brain surgery. Most will opt Botox injections due to lower risks.