Ahsan Marya, Nizami Deba Jalal
Department of Pharmacology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
Department of Obstetrics and Gynaecology, Latifa Hospital, Dubai Health Authority, Dubai, UAE.
Indian J Pharmacol. 2024 Sep 1;56(5):358-360. doi: 10.4103/ijp.ijp_284_24. Epub 2024 Dec 16.
Metformin, an insulin-sensitizer, is used in the treatment of polycystic ovarian syndrome (PCOS) in obese women as it helps in weight loss and regularizes the menstrual cycle. However, impaired absorption of Vitamin B12 due to metformin has also been hypothesized. Here, we report the case of a 39-year-old woman prescribed metformin for PCOS, presenting with an unusual symptom of eyelid myokymia. She developed distressing unilateral eyelid twitching, not responsive to conservative management or oral methylcobalamin. She was a nonsmoker, nonalcoholic, and nor caffeine-abuser. Other confounding factors such as stress, sleep deprivation, or eye strain were not evident. The only significant finding was borderline low Vitamin B12 levels. The symptoms subsided on discontinuation of metformin and reappeared when metformin was reintroduced. Although eyelid myokymia is a self-limiting benign condition, it can also be triggered by drugs and affect the quality of life. Practitioners should monitor Vitamin B12 levels during metformin therapy to prevent adverse effects.
二甲双胍作为一种胰岛素增敏剂，用于治疗肥胖女性的多囊卵巢综合征（PCOS），因为它有助于减肥并使月经周期规律。然而，也有假设认为二甲双胍会导致维生素B12吸收受损。在此，我们报告一例39岁因PCOS而服用二甲双胍的女性病例，该患者出现了眼睑肌纤维颤搐这一不寻常症状。她出现了令人苦恼的单侧眼睑抽搐，对保守治疗或口服甲钴胺均无反应。她不吸烟、不饮酒、也不滥用咖啡因。压力、睡眠不足或眼疲劳等其他混杂因素并不明显。唯一显著的发现是维生素B12水平略低。停用二甲双胍后症状缓解，重新服用二甲双胍时症状再次出现。虽然眼睑肌纤维颤搐是一种自限性良性疾病，但它也可能由药物引发并影响生活质量。从业者在二甲双胍治疗期间应监测维生素B12水平，以预防不良反应。
