{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:33:13Z","timestamp":1787841193901,"version":"build-2784847793"},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>","DOI":"10.4103\/ijp.ijp_284_24","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T05:01:11Z","timestamp":1734411671000},"page":"358-360","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Metformin-induced eyelid myokymia"],"prefix":"10.4103","volume":"56","author":[{"given":"Marya","family":"Ahsan","sequence":"first","affiliation":[{"name":"Department of Pharmacology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deba Jalal","family":"Nizami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Latifa Hospital, Dubai Health Authority, Dubai, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12,16]]},"reference":[{"key":"R1-20241217","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13048-022-01091-0","article-title":"Insulin resistance in polycystic ovary syndrome across various tissues: An updated review of pathogenesis, evaluation, and treatment","volume":"16","author":"Zhao","year":"2023","journal-title":"J Ovarian Res"},{"key":"R2-20241217","first-page":"50","article-title":"Review of the case reports on metformin, sulfonylurea, and thiazolidinedione therapies in type 2 diabetes mellitus patients","volume":"11","author":"Susilawati","year":"2023","journal-title":"Med Sci (Basel)"},{"key":"R3-20241217","first-page":"e30447","article-title":"Comparison of serum Vitamin B12 levels among drug-na\u00efve and metformin-treated patients with polycystic ovary syndrome","volume":"14","author":"Kamrul-Hasan","year":"2022","journal-title":"Cureus"},{"key":"R5-20241217","doi-asserted-by":"crossref","first-page":"585","DOI":"10.4239\/wjd.v14.i5.585","article-title":"Association between metformin and Vitamin B12 deficiency in patients with type 2 diabetes","volume":"14","author":"Sayedali","year":"2023","journal-title":"World J Diabetes"}],"container-title":["Indian Journal of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_284_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:45:57Z","timestamp":1787838357000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_284_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ijp.ijp_284_24","relation":{},"ISSN":["0253-7613","1998-3751"],"issn-type":[{"value":"0253-7613","type":"print"},{"value":"1998-3751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"2024-04-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}