JULY 1998 MONTHLY NEWLETTER

Georgetown Health Care Center Georgetown Pharmacy

Fasciculation of the eyelid, usually referred to as "twitching," is a seldom serious and relatively common condition. It usually occurs on the lower eyelid of one eye and does not affect vision. It can be, however, extremely annoying.

The nerve endings in the eyelids can be irritated by stress, fatigue, caffeine, and tobacco. The irritation causes the release of excessive amounts of the neurotransmitter acetylcholine, which causes the bundles of muscle fibers in the eyelid to contract repeatedly. In most cases the problem is only slightly notcieable to others, although ther person to whom it is occurring may feel as though his or her eye is constantly and uncontrollably winking.

The way to stop the twitching is to avoid what causes it - get plenty of rest and relaxation, and avoid caffeine and tabacco when possible. The condition may go away in a fe days when these stressors are eliminated.

The twitching can be serious in some instances. If other facial muscles contract along with the eyelid, there may be an underlying neurological problem. Some people - older women are particularly susceptible - may develop spasms that can force their eyelids shut. This condition, called blepharospasm, is debilitating but may be treated with an injection of botulinum toxin A into the eyelid muscles. Surgery may be necessary in some cases.

One well established risk factor for testicular cancer is undescended testes. A recent report has concluded that a positive family history for testicular cancer is another important risk factor.

The authors of a report published in Cancer (1997; 80:1954-60), found that genetic predisposition is a definite independent risk factor for testicular germ cell tumors. A first-dgree family history of testicular cancer confers a 3 to 10 fold increased relative risk of developing the disease.