Uncontrollable Head Shaking and Facial Twitches: Neurological Symptoms

Involuntary head shaking, eye twitching, and eyebrow twitching?

Hello Doctor, my father (56 years old) who recovered from lymphoma four years ago has been experiencing these symptoms for a while, but they have recently worsened.
1.
Symptoms: involuntary head shaking (mostly side to side, but also a bit of nodding), and slight movements of the eyes, eyebrows, and facial muscles (similar to when facial muscles feel stiff and one wants to stretch them).
The main symptoms are head shaking and twitching of the eyes and eyebrows.
These symptoms occur simultaneously and resemble a mild episode of Tourette syndrome, but they are not as intense.
During today's episode, he moved 5 to 6 times in a row, with intervals of about 1 to 2 seconds.
2.
Recent situations when these occurred: riding a motorcycle and standing still while cooking.
3.
The symptoms do not occur when he is focused or needs to move around.
4.
Upon asking my father, he mentioned that these situations feel "unconscious" to him, and he is not aware of them.
Previously, the "conscious" head shaking was due to suddenly feeling like he couldn't get enough oxygen while cooking.
Thank you, Doctor! I appreciate your help!

Xiaolan, 20~29 year old female. Ask Date: 2021/05/15

Dr. Zhang Junwei reply Neurosurgery

It is recommended to schedule a neurology outpatient examination.

Reply Date: 2021/05/15

More Info

Uncontrollable head shaking and facial twitches can be concerning symptoms, especially considering your father's medical history of lymphoma. These symptoms may suggest a neurological condition that warrants further evaluation. Let's break down the potential causes and considerations for these symptoms.

Possible Causes
1. Neurological Disorders: The symptoms described, particularly the involuntary head shaking and facial twitches, could be indicative of several neurological disorders. Conditions such as Tourette syndrome, essential tremor, or even dystonia could present with similar involuntary movements. While Tourette syndrome is characterized by tics, essential tremor typically involves rhythmic shaking, which can affect the head and other parts of the body.

2. Medication Side Effects: If your father is on any medications, especially those related to his previous cancer treatment or any psychiatric medications, it’s essential to consider that these symptoms could be side effects. Some medications can cause movement disorders, known as extrapyramidal symptoms.

3. Anxiety and Stress: Given that the symptoms seem to occur during specific activities (like cooking or riding a motorcycle), it may also be related to anxiety or stress. Stress can exacerbate involuntary movements, and if your father feels a sudden sensation of not being able to breathe, it could trigger a panic response, leading to these involuntary movements.

4. Post-Cancer Treatment Effects: After cancer treatment, some patients experience neurological symptoms due to changes in the brain or nervous system. This could be related to chemotherapy, radiation, or even the cancer itself. Neurological assessments are crucial in these cases.

5. Other Medical Conditions: Conditions such as Parkinson's disease or other neurodegenerative disorders could also present with similar symptoms, especially if there is a family history or other risk factors involved.

Recommendations
1. Neurological Evaluation: It is crucial for your father to see a neurologist for a comprehensive evaluation. The neurologist may perform a physical examination, neurological tests, and possibly imaging studies (like an MRI) to assess for any underlying conditions.

2. Medication Review: A thorough review of his current medications with his healthcare provider is essential. If any medications are contributing to these symptoms, adjustments may be necessary.

3. Monitoring Symptoms: Keeping a detailed log of when these symptoms occur, their duration, and any associated activities or stressors can provide valuable information for the healthcare provider.

4. Stress Management: If anxiety or stress is a contributing factor, exploring relaxation techniques, counseling, or cognitive-behavioral therapy may help manage these symptoms.

5. Support and Education: Educating your father and family about these symptoms and potential conditions can help in managing anxiety related to the symptoms. Support groups for individuals with similar experiences can also provide comfort and understanding.

Conclusion
In summary, the symptoms your father is experiencing could stem from a variety of causes, including neurological disorders, medication side effects, or stress-related responses. A thorough evaluation by a neurologist is essential to determine the underlying cause and appropriate treatment. Early intervention can significantly improve quality of life and help manage symptoms effectively. Please ensure that your father seeks medical attention promptly to address these concerning symptoms.

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