Eye twitching is a common symptom that can be caused by factors such as stress, lack of sleep, excessive caffeine intake, alcohol use, inner ear disorders, or certain medications. In some cases, eye twitching may also be linked to more serious conditions, including stroke, multiple sclerosis, or brain tumors.
When eye twitching affects only the eyelid, it is often related to involuntary muscle contractions triggered by fatigue, anxiety, or stimulant use. However, eye twitching that occurs with dizziness, balance problems, speech changes, or vision issues may indicate a neurological or inner ear condition.
Treatment for eye twitching depends on the underlying cause and may include lifestyle changes, hydration, medication adjustments, or targeted medical therapies. In rare situations, eye twitching associated with neurological conditions or tumors may require specialized treatment such as surgery, chemotherapy, or radiation therapy.
Main causes
The main causes of eye twitching include:
1. Excess stress
Excess stress can be associated with eye twitching because it affects normal muscle function, leading to involuntary contractions.
What to do: If stress is identified as the underlying cause, a healthcare provider may suggest talk therapy and lifestyle modifications, including regular exercise and a balanced diet. In some cases, medications such as sertraline, paroxetine, or propranolol might also be prescribed.
2. Heavy alcohol consumption
Eye twitching may occur after heavy alcohol consumption due to the effects of alcohol on the nervous system.
Drinking excessive amounts of alcohol can also cause poor coordination and balance, slurred speech, difficulty walking, and vomiting.
What to do: Eye twitching usually improves within a few hours as the body metabolizes alcohol.
In more severe cases, hospital treatment may be required, including intravenous (IV) hydration.
3. Stroke
Eye twitching is common in strokes that affect the cerebellum. Symptoms usually appear suddenly and, in addition to eye twitching, may include dizziness, nausea, and slurred speech. Learn more about stroke symptoms.
What to do: If a stroke is suspected, go immediately to the emergency department or call 911.
Treatment may involve medications such as antihypertensives, thrombolytics, and anticoagulants, and, in more severe cases, surgery.
4. Sleep deprivation
Sleep deprivation is a possible cause of eye twitching and may also lead to symptoms such as difficulty concentrating, irritability, and fatigue.
What to do: Practice good sleep habits by keeping your bedroom quiet and dim, and by avoiding TV, cell phones, and computers for about two hours before bedtime.
5. Excessive caffeine intake
Consuming too much caffeine, found in foods and drinks such as coffee, chocolate, green tea, and energy drinks, can increase the likelihood of eye twitching.
High caffeine intake may also cause nausea, vomiting, seizures, rapid heartbeat, irritability, headaches, and, in rare cases, death.
What to do: In mild cases, drinking water is usually sufficient. In more severe cases, hospital treatment may be needed, including IV hydration and medications such as metoprolol, lorazepam, or norepinephrine.
In some situations, stomach lavage may be recommended to help remove caffeine from the stomach.
6. Labyrinthitis
Eye twitching can occur with labyrinthitis, but symptoms like nausea, vomiting, and vertigo are more common. Read more about labyrinthitis symptoms.
Labyrinthitis is usually caused by viral infections, such as the flu or a common cold, but it can also result from bacterial infections, including middle ear infections or meningitis.
What to do: In most cases, labyrinthitis does not require specific treatment, and rest along with adequate fluid intake is recommended.
In some cases, a healthcare provider may prescribe antihistamines or benzodiazepines to help relieve symptoms.
7. Medication use
Eye twitching can be a side effect of certain medications, including anticonvulsants and antidepressants, especially when used in high doses or incorrectly.
What to do: If a medication side effect is suspected, consult the prescribing provider for evaluation. The medication may need to be adjusted or replaced.
Only take medications under medical supervision and always follow the doctor’s instructions.
8. Benign paroxysmal positional vertigo
Benign paroxysmal positional vertigo is an inner ear condition that can cause eye twitching in both eyes.
Other symptoms may include dizziness, a spinning sensation, nausea, and vomiting.
What to do: Treatment may include specific head exercises and, in some cases, antihistamines to help reduce symptoms.
9. Illicit drug use
Eye twitching may occur with the use of certain illicit drugs, such as amphetamines, LSD, or ecstasy.
Other symptoms may include agitation, a rapid heartbeat, difficulty thinking clearly, hallucinations, and delusions, depending on the substance used.
What to do: Eye twitching usually goes away as the drug’s effects fade. Using illegal drugs is dangerous and not recommended. If you think you might be dependent, it’s best to talk to a psychiatrist.
10. Multiple sclerosis
Multiple sclerosis is another possible cause of eye twitching, particularly when it affects the cerebellum, which is responsible for motor learning and coordination.
What to do: Once diagnosed, treatment may include medications such as anticonvulsants, immunosuppressants, pain relievers, and muscle relaxants to help manage symptoms.
11. Brain tumors
Although rare, eye twitching may be a sign of brain tumors, especially when they occur in the cerebellum.
In these cases, other symptoms may also appear, such as headaches, double vision, nausea, and loss of balance.
What to do: If a brain tumor is suspected, a neurologist should be consulted for a thorough evaluation. Treatment may include surgery, chemotherapy, and radiation therapy, depending on the case.
Eye twitching in the lower eyelid
Eye twitching in the lower eyelid may indicate eyelid myokymia, a condition that usually affects only one eye and most often involves the lower eyelid.
The exact causes of eyelid myokymia are not fully understood, but they are commonly linked to stress, anxiety, excessive fatigue, and high caffeine intake.
Also recommended: Eyelid Twitching: 9 Common Causes & When to See a Doctor tuasaude.com/en/eyelid-twitching