Facial Twitching: Causes, Symptoms, and Treatment Options - Neurology

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Facial twitching?


Hello Doctor: Since yesterday, I have been experiencing involuntary muscle twitching on the right side of my face.
During the twitching, the muscles under my right eye also twitch, and my right upper eyelid feels like it is drooping.
The duration of the twitching is irregular, but it is quite frequent, and it has been continuously shaking for the past two days.
Currently, I have no symptoms in other areas.
Could this be a sign of facial nerve palsy or a precursor to a stroke? My daily routine is normal, with sleep from 12:00 AM to 7:30 AM, and my work requires me to look at the computer for long periods.
Is it advisable to supplement with B vitamins (will this help)? Thank you.

Anjing, 40~49 year old female. Ask Date: 2019/12/09

Dr. Jiang Junyi reply Neurology


Hello: Your symptoms may suggest blepharospasm, which often has an unknown cause and is three times more common in females than in males, typically occurring after the age of forty.
Common causes include dry eye syndrome, high levels of stress, eye inflammation, light sensitivity, consumption of caffeine and tobacco, dysfunction of the basal ganglia, Parkinson's disease, and certain psychiatric medications.
The most common cause of hemifacial spasm is compression of the seventh cranial nerve by a blood vessel or a tumor in the cerebellopontine angle.
It is recommended to relax, get plenty of rest, ensure adequate sleep, reduce caffeine and tobacco intake, apply warm compresses and massage the eyelids, and wear sunglasses outdoors to minimize bright light exposure.
Symptoms usually do not last long.
If symptoms persist for more than a week, it is advisable to consult an ophthalmologist and a neurologist promptly.
According to current health insurance regulations, patients with severe blepharospasm or hemifacial spasm that causes significant inconvenience and symptoms lasting over six months, diagnosed by an ophthalmologist, may apply for botulinum toxin treatment, which can be administered three times a year.
It is suggested that you consult with both an ophthalmologist and a neurologist for discussion and examination.
Wishing you good health and peace.
Dr.
Jiang, Neurology Department, cares about you.

Reply Date: 2019/12/09

More Info


Facial twitching, also known as facial spasms or involuntary muscle contractions, can be a concerning symptom that may arise from various underlying conditions. Based on your description, it seems you are experiencing involuntary muscle movements in the right side of your face, particularly around the eye area. This could be indicative of several potential issues, including facial nerve disorders, stress, or even neurological conditions.


Causes of Facial Twitching
1. Facial Nerve Disorders: One of the most common causes of facial twitching is related to the facial nerve (cranial nerve VII). Conditions such as Bell's palsy, which leads to temporary weakness or paralysis of the facial muscles, can result in twitching or spasms.
2. Hemifacial Spasm: This condition is characterized by involuntary muscle contractions on one side of the face. It is often caused by irritation of the facial nerve, which can occur due to blood vessel compression or other factors.

3. Stress and Fatigue: High levels of stress and fatigue can lead to muscle tension and spasms. If you are working long hours in front of a computer, this could contribute to your symptoms.

4. Neurological Conditions: While less common, conditions such as multiple sclerosis or dystonia can cause involuntary muscle movements. It is essential to rule out these serious conditions, especially if the twitching persists or worsens.

5. Nutritional Deficiencies: Deficiencies in certain vitamins, particularly B vitamins, can lead to muscle spasms and twitching. While you mentioned considering vitamin B supplementation, it is crucial to consult with a healthcare provider before starting any new supplements.


Symptoms to Monitor
In addition to the twitching, you should be aware of other symptoms that may accompany your condition. These can include:
- Changes in facial sensation or strength
- Pain or discomfort in the affected area
- Changes in vision or eye function
- Any signs of weakness or paralysis in other parts of the body

When to Seek Medical Attention
Given your symptoms, it is advisable to consult a healthcare professional, particularly a neurologist, to evaluate your condition further. They may perform a physical examination, review your medical history, and possibly order imaging studies or other diagnostic tests to determine the underlying cause of your facial twitching.


Treatment Options
Treatment for facial twitching will depend on the underlying cause. Here are some potential options:
1. Medications: If a specific condition is diagnosed, medications may be prescribed to manage symptoms. For example, muscle relaxants or anticonvulsants may be effective for conditions like hemifacial spasm.

2. Botulinum Toxin Injections: For persistent facial spasms, botulinum toxin (Botox) injections can help relax the muscles and reduce twitching.

3. Physical Therapy: In some cases, physical therapy may be beneficial to improve muscle control and reduce spasms.

4. Stress Management: If stress is a contributing factor, techniques such as mindfulness, yoga, or cognitive-behavioral therapy may help alleviate symptoms.

5. Nutritional Support: If a deficiency is suspected, dietary changes or supplements may be recommended to ensure adequate intake of essential nutrients.


Conclusion
Facial twitching can be a benign condition, but it can also indicate more serious underlying issues. Given the frequency and persistence of your symptoms, it is crucial to seek medical evaluation to rule out any serious conditions, such as a stroke or neurological disorder. Early intervention can lead to better outcomes and help alleviate your concerns. Remember to maintain a balanced lifestyle, manage stress, and consider discussing any nutritional supplements with your healthcare provider.

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