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Victory over vicious eyelid twitching

 •  • by Paul Ingraham
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This summer I developed a case of bad, bad blepharospasm — twitching eyelid. Maddening! Like hiccups that wouldn’t go. I tried hard to ignore it for a long time, to give it no attention, to be very Zen about it. Because the only thing worse than a jittery eyelid is being emotionally fixated on it.

I have a lot of experience with muscle twitching, more generally known as fasciculation. It’s a part of my <a href='https://tryeverything.substack.com/p/its-like-long-covidown struggles with chronic pain over the last several years. A random muscle goes off on me a couple times a day — delicate vibrations, erratic fluttering, or mighty cramp-like pulses. Most episodes last seconds or a few minutes at most, but a few times a year I get one that lasts for hours or days. The only consistent feature is a repeating contraction I didn’t order.

Animated illustration of a muscle repeatedly contracting

In 2014, I had an unforgettable battle royale with a twitch in my back (latissimus dorsi) that persisted, intermittent but frequent, for… eight months. These were strong contractions that would thump away at me, like someone knocking on my back, for 10–30 minutes at a time, several times per week, often disrupting sleep. To say that was frustrating and worrisome would be an understatement. In the early stages, I thought it was possible it would cause some kind of mental breakdown, but ultimately it simply demonstrated that the brain can adapt to almost anything. Eventually that particular twitch simply went away, and I have never felt it again since.

So I have been taught by harsh experience not to just assume that a fasciculation will back off. It probably will. It might not. And this eyelid twitch was escalating, until my eyelid was jittering basically full-time. Which was as miserable as it sounds.

But there’s a happy ending! I found a solution that worked for me: eyedrops. Dr. Google told me a common cause of this problem is just dry eyes, so I started taking more screen breaks and using some good quality eyedrops frequently, and it worked. I am celebrating a rapid 80-90% reduction in eyelid twitching, which has held steady for three weeks now — so I think it’s safe to declare victory. Yahtzee!

And now here’s an interesting thought: how many unwanted muscle contractions are a reaction to some kind of irritation? 🤔

Not everybody beats blepharospasm

I was lucky with my easy fix. It’s quite rare, but some people never recover from blepharospasm — a persistent and even progressive dystonia, highly distressing.

Muscle behaviour can be bizarre, and pathologically severe fasciculations are a good reminder that we have a great deal still to learn about how muscle works.

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