Clinical case review

A 63-year-old woman with persistent periocular twitching

James Colebatch



What is the likely cause of this patient’s continuing rhythmic twitching underneath her left eye and how can she be treated?

Article Extract

Case scenario

A 63-year-old woman presented with a four-month history of continuing rhythmic twitching underneath her left eye. She could not feel it and was not aware of it unless she observed it in a mirror. The area concerned appeared to be near the point of contact of her spectacles on the inferior margin of her orbicularis oculi muscle. The twitching was regular at about 120 per minute. She was not tired, stressed or taking medication and she did not drink coffee. She had no other health problems, felt well and energetic and did not suffer from any other muscle spasms and cramps.

Why is the twitching happening and can she be treated?