Eye Twitching and Facial Muscle Spasms: When to Seek Help

Eyelid twitching and facial muscle spasms?

I started experiencing frequent twitching in my left upper eyelid about three months ago.
After approximately two months, the twitching has decreased but still occurs.
Subsequently, my left eye's vision began to blur, and I have been experiencing excessive tearing.
When looking at white lights, I see a halo effect, and white walls appear yellow.
I'm unsure if this is related to the eyelid twitching.
Today, when I made a facial expression, my left side of the face twitched significantly (from the lower left eye to the lower left corner of the mouth).

Three months ago, I experienced sudden numbness extending from my neck to behind my ear and down both arms.
Additionally, after a massage, I felt significant pain on the right side of my head, while the left side of my head was completely pain-free.
I do not have drooling, facial asymmetry, or any facial pain.
Should I consult a neurologist or a neurosurgeon? Thank you.

Mimi, 30~39 year old female. Ask Date: 2016/04/07

Dr. Gao Chunde reply Neurology

There should be a lesion in the intracranial area, and prompt medical attention is necessary.
It is advisable to first consult a neurologist, who may refer you to relevant specialties for further management if needed.

Reply Date: 2016/04/07

More Info

Based on your description, it sounds like you are experiencing a combination of symptoms that could be related to several underlying conditions. The twitching of your left upper eyelid, the blurred vision, and the changes in your perception of light could all be interconnected. Additionally, the facial spasms and the numbness you experienced in your neck and arms are concerning and warrant further evaluation.

Eye twitching, or myokymia, is often benign and can be triggered by stress, fatigue, caffeine intake, or eye strain. However, when accompanied by other symptoms such as blurred vision and facial spasms, it may indicate a more serious issue. The fact that you are experiencing a "halo" effect around lights and a yellow tint to white surfaces suggests that there may be an issue with your eye health, possibly related to the retina or the optic nerve.

The facial spasms you described, particularly the large-scale shaking from the lower eye to the corner of your mouth, could indicate a condition known as hemifacial spasm. This condition is characterized by involuntary muscle contractions on one side of the face and can be caused by irritation of the facial nerve, often due to a blood vessel compressing the nerve. It is essential to differentiate between benign muscle spasms and more serious neurological conditions.

Given the combination of symptoms, including the numbness in your neck and arms, it is crucial to seek a comprehensive evaluation. You should consider seeing a neurologist, as they specialize in conditions affecting the nervous system, including muscle spasms, nerve compression, and other neurological disorders. A thorough neurological examination, possibly including imaging studies such as an MRI, may be necessary to rule out any serious conditions.

Additionally, if your symptoms persist or worsen, it may be beneficial to consult with an ophthalmologist to address the visual disturbances you are experiencing. They can assess your eye health and determine if there are any underlying issues that need to be addressed.

In summary, while some of your symptoms may be benign, the combination of eye twitching, blurred vision, and facial spasms, along with the numbness, suggests that a thorough evaluation by a neurologist is warranted. Early diagnosis and intervention can be crucial in managing any potential underlying conditions effectively. Please do not hesitate to seek medical attention to ensure your health and well-being.

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