When increasing Topamax to 200 mg daily I noticed my husband has a constant, rhythmic lip twitch which he is not aware of. Also has an intermittent eye muscle twitch which he can notice when it affects the eye movement, but not when it pulses up toward his temple. He is also complaining of having a fog or mucous over his eyes during part of the day. His migraines became more frequent and more painful with this dose. He is taking this for occular migraines, so when the increase to 200mg started causing trouble, he decreased to 100 mg daily. I noticed that the lip and eye twitching became much worse with the decrease in doseage, I read somewhere that this could happen with a decrease in doseage, but not with an increase.