Eyelid twitching refers to the frequent involuntary twitching of the eyelids, extending to the eyebrow area, which cannot be controlled voluntarily. If it occurs occasionally, it is not considered a pathological condition.

This symptom Shenshi Yaohan is referred to as "spleen wheel twitching"; Mujing Dacheng is called "twitching eyelid (blepharospasm)". It is commonly known as "eyebrow twitching" nowadays.

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1. Blood Deficiency Producing Wind︰The main clinical manifestations include frequent twitching of the eyelids that cannot be stopped spontaneously, dry and occasionally itchy eyes, a dull complexion, pale lips and tongue, and a thin pulse. The primary cause is prolonged visual strain depleting blood or excessive blood loss, leading to liver blood deficiency and insufficient yin blood to nourish the eyelids. Blood deficiency generates wind, resulting in frequent twitching of the eyelids that cannot be stopped, along with dry and occasionally itchy eyes. Therefore, the key diagnostic points of this condition are eyelid twitching, dry and itchy eyes, accompanied by symptoms of blood deficiency. The treatment principle is to nourish blood and disperse wind, with the recommended prescription being Chinese Angelica Blood-Activating Decoction supplemented with scorpion.
2. Spleen-Stomach Qi Deficiency︰The eyelid frequently twitches, the eyes ache with fatigue, the eyelashes lack strength, the complexion is shallow yellow, there is poor appetite and weariness, dizziness and blurred vision, the tongue is pale and swollen with a white and moist coating, and the pulse is deep and thin. This is due to factors such as diet, overstrain, and excessive contemplation damaging the spleen and stomach. Spleen-stomach qi deficiency leads to impaired transportation and transformation. Since the eyelid belongs to the spleen, spleen deficiency fails to restrain the eyelid, resulting in frequent twitching and weak eyelashes. Due to qi deficiency, systemic symptoms such as fatigue, lack of strength, and shortness of qi are also present. Therefore, the key diagnostic features of this condition are eyelid twitching, weak eyelashes, and spleen-stomach qi deficiency. Treatment should focus on replenishing and tonifying the qi of the spleen and stomach, and the recommended formula is Middle-Tonifying Qi-Replenishing Decoction.
3. Wind-heat External Invasion︰The twitching of the eyelids is less frequent than before, often accompanied by red, itchy, and painful eyes, as well as moist and ulcerated eyelids, along with headache, aversion to wind, chills, fever, a red tongue with white coating, and a floating, rapid pulse. When wind-heat pathogens invade the eye orifices and affect the eyelids, it leads to frequent twitching. The interaction of wind and heat causes red, itchy, and painful eyes, along with symptoms such as headache and aversion to wind. The treatment involves dispersing wind and clearing heat, using the Fangxuan Qufeng Sanre Yinzi (Wind-Dispersing and Heat-Clearing Decoction).

bubble_chart Documentation

1. Shenshi Yaohan．Spleen disease: "Eyelid twitching syndrome. This condition refers to the involuntary twitching of the eyelids, which occurs without the person's control over opening or closing them. It is a disorder of qi, related to the liver and spleen meridians. People often call it wind, but they do not realize that it is actually due to blood deficiency and the disharmony of qi, not purely wind. If there is redness and ulceration along with recurrent headaches, then it is caused by pathogenic wind. If left untreated for a long time, it can lead to facial distortion."