Which factor commonly precipitates myokymia?

• A. Caffeine and stress
• B. Exposure to bright light
• C. Bacterial infection
• D. Systemic disease

Answer: (A)

Eyelid myokymia is a benign, self-limited twitching of the eyelid caused by spontaneous discharges of the orbicularis oculi muscle. It is commonly precipitated by fatigue and stress, with stimulants like caffeine acting as frequent triggers because they boost neuromuscular excitability and reduce inhibitory control over the facial muscles. Bright light exposure isn’t a typical precipitant for myokymia, and a bacterial infection would produce noticeable conjunctival symptoms rather than isolated twitching. Systemic disease can cause neuromuscular signs, but it’s not the usual factor that triggers simple eyelid myokymia. So caffeine and stress best explain the common precipitating factor.