Eyelid Myokymia—a Presumed Manifestation of Coronavirus Disease 2019 (COVID-19)

Abstract

The purpose of this study is to report eyelid myokymia in patients recently recovered from COVID-19 disease. A cohort of 15 patients who developed eyelid myokymia during or immediate post-recovery of systemic disease were evaluated. Demographic, clinical characteristics, effect of age, and hospitalization on the disease course were studied. The disease course was evaluated every month for 3 months period. All, except 2, patients had complete resolution of lid myokymia within 3 months of onset. Median [IQR] myokymia recovery time was 42 [31,60] days. Age and duration of hospitalization had a significant linear relationship with myokymia recovery time. Recovery was delayed by 2.64 days with every 1-year increment in age and by 6.19 days with every additional day of hospital stay. Recovery time was independent of severity of systemic disease ( P = .055) and gender ( P = 0.2). Eyelid myokymia can be a possible manifestation of COVID-19 recovery phase. While myokymia recovers gradually in all these patients, older age and a longer duration of hospitalization are associated with slower recovery.

Eyelid myokymia caused by a trigeminal schwannoma as determined by the trigeminal‐evoked blink reflex

“…Eyelid myokymia, although thought to originate from peripheral nerves such as the facial nerve, may be triggered by extrinsic factors [3][4][5] or the synkinetic facial nerve innervation induced by swallowing. 13 Furthermore, central nervous system diseases can also be a causative factor.…”

“…1,2 This entity, which is considered benign, originates from peripheral nerves and is triggered by extrinsic factors such as stress, excessive caffeine consumption, drugs, viral infection or physical exertion; central nervous system diseases are rarely the cause. [3][4][5] Although several cases of eyelid myokymia associated with intracranial lesions have been reported, its pathogenesis remains unclear. [6][7][8][9][10][11] We describe the case of a patient with trigeminal schwannoma localized to the Meckel's cave, who presented with eyelid myokymia, as determined by the trigeminal-evoked blink reflex.…”

“…Eyelid myokymia is a localized involuntary contraction of the orbicularis oculi muscle, a self‐limiting condition that lasts for seconds to hours, and rarely for weeks 1,2 . This entity, which is considered benign, originates from peripheral nerves and is triggered by extrinsic factors such as stress, excessive caffeine consumption, drugs, viral infection or physical exertion; central nervous system diseases are rarely the cause 3–5 . Although several cases of eyelid myokymia associated with intracranial lesions have been reported, its pathogenesis remains unclear 6–11 .…”

Eyelid Nystagmus and Other Involuntary Movements of the Upper Lids; What's in a Name?

“…It is a benign, usually unilateral, self‐limiting phenomenon experienced by otherwise healthy individuals and associated with fatigue, anxiety and depression, excessive caffeine intake, and some drugs. More persistent eyelid myokymia can be encountered in multiple sclerosis, Guillain Barre syndrome, brainstem tumors, and in the setting of coronavirus disease 2019 infection 10 . Eyelid myoclonus can occur as a generalized epileptic phenomenon usually with absences and precipitated by eye closure in the light 11 .…”

Acetazolamide-Induced Periorbital Myokymia: A Case Report

“…Facial myokymia occurs either as a persistent rapidly flickering contraction involving the facial musculature (in particular the lower part of the orbicularis oculus) or a contraction that spreads slowly across the face. While varying muscle groups can be affected, eyelid myokymia is the most common cause of facial involuntary muscle movement disorders [ 4 ]. The underlying etiology associated with myokymia varies; when associated with muscle cramping and diaphoresis, it may occur as part of Isaacs syndrome, neuromyotonia, episodic ataxias, any condition increasing peripheral nerve excitability (e.g., excessive caffeine intake) and brainstem lesions usually involving the facial nerve are additional diseases linked to myokymia [ 5 ].…”