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droopy eyelid
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droopy eyelid

I started twitching in April.  June I had a clean EMG.  Doctor said stress. I have twitched ever since (sometimes numbness and tingling and the tingling even occurs in my head on occasion).  I am now experiencing my left eyelid droops a little more than right.  It is nothing noticeable unless one looks closely. My husband can see it but must look carefully.  I am afraid this could be neurological in nature as my eyes twitch often, even when I sneeze or shut them quickly they will begin twitching. Can stress do this? What about ALS? I do not have noticeable weakness anywhere, but this eyelid is starting to worry me.  Please tell me your thoughts.
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Dear Beth:

Sorry that your eyelid is giving you problems.  I would tell you that you do not have ALS.  We see EMG changes before fasciculations in ALS, and definite muscle weakness before fasciculations.  It would be unusual to have isolated eyelid weakness in ALS, especially since you have had symptoms since april.  I think the most likely explanation for the droop is that the fasciculations are draining the strength from the muscle that raising the lid and you have a very minor droop.  The eye muscles are extremely sensitive to changes in energy level and usage.  After a very prolonged time of use (as in a fasciculation) there might be a lid droop.  I would say the droop is more muscular than nerve and most likely will resolve as the benign fasciculations resolve.

Sincerely,

CCF Neuro MD
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