Topiramate-Induced Persistent Eyelid Myokymia

Topiramate (TPM) is a psychotropic drug, which is used mainly as an antiepileptic drug and now over the years isused for a wider range of indications, including migraine prophylaxis and binge eating disorders. Although ocular side effectsof Topiramate have been frequently reported, neuroophthalmologic manifestations such as myokymia are rarely reported.CasePresentation. This case report presents a case of a 47-year-old woman who had begun TPM for binge eating problem. She developedunilateral long standing lower eyelid twitching, which progressed to upper eyelid and eyebrow at the same side. The patient was not asmoker or excessive alcohol or caffeine abuser. Increasing the resting time and changing life style made no significant changes in hereyelid twitching. There was no definite evidence by neuroimaging and clinical or laboratory evaluations causing eyelid myokymia.The symptoms resolved with discontinuation of TPM.Conclusion. Although eyelid myokymia is a benign and self-limited condition,it sometimes becomes a source of distress in chronic long standing cases. Physicians should be aware of the neuroophthalmologicside effects of this drug