Dr. Aida Abaz Quka
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I developed an eye tic two years back, where I was forcefully blinking my right eye. I did this for around five months which affected my daily life. Then, with the practice of meditation and breathing exercise, the tic reduced drastically. But I think it altered the movements of my right eye and might have inflamed my eye muscles or nerve. When moving my right eye, I felt a lack of coordination between my eye and the brain. I feel an immense stabbing pain for around 18 months in my right eye. The pain gets worse when I move my eye. However, when I change environment, the pain decreases, for example, I am on holidays right now and with my loved ones, I feel the pain reduced. But the discomfort during eye movements is still there, as if I am self-conscious about my movement right now. The muscles or nerves around my right eye feel tensed and tired. I constantly think about my right eye and the difficulties that I am going through. I have done an MRI and CT scan, and the result came normal. I did a vitamin B12 test recently, and the results were normal. I was taking vitamin B complex tablets and have stopped taking them. My results come out normal whenever I do laboratory tests, except that I have raised cholesterol levels which have been present for the past two years. I did ophthalmic tests, but the results came normal, and the ophthalmologist advised me to see a neurologist.
I feel sad and stressed. Kindly help me find a solution for this.
Hello,
Welcome to icliniq.com.
I understand your concern and recommend starting Gabapentin or low-dose Clonazepam to help release muscle tension. Another possible treatment option is Fluvoxamine, which can help treat OCD (obsessive-compulsive disorder) and psychogenic tics like in your case. I hope you will find this information helpful. I remain at your disposal in case of further questions whenever you need me.
Thanks and regards.
Patient's Query
Hi doctor,
Thank you for your response, doctor. I appreciate it. I have a few questions. Please advise on the dosage and duration of the medication. When I eat or engage in absorbing sports activities, I do not feel the pain and the movement discomfort a bit. It seems to reduce. Have you ever encountered such a case in your career and seen it heal? Is there a way I can get in touch with you for a follow-up as I take the medication?
Kindly suggest and thank you very much.
Hi,
Welcome back to icliniq.com.
Yes, it seems to be a psychogenic tic, based on your description. I have had patients like you. I recommend that you take the prescription from your doctor. I suggest you take Fluvoxamine 75 mg, start with one fourth or one quarter tablet at bedtime for a week, then half a tablet at bedtime for a week, and then continue on one tablet at bedtime. However, you can ask a direct for a follow-up.
I hope you will find this information helpful.
Kind regards.
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Neurology
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