Facial Twitching and Arm Symptoms: When to Seek Medical Advice

Q: Facial Twitching and Arm Symptoms: When to Seek Medical Advice

Hello： You mentioned that "the right cheek still has noticeable involuntary twitching. <br>After testing, it was found that the twitching of the right cheek is triggered by movements involving the left arm," which may indicate a neurological dysfunction affecting the motor area f

Facial twitching?

Hello, Doctor Jiang.
I have two questions to ask.

About two years ago, I was rehabilitating at home for frozen shoulder when I suddenly noticed that my right cheek would involuntarily twitch while performing a stretching exercise that involved making large circles with both arms forward.
At the time, I didn't think much of it, assuming it was related to the frozen shoulder.
Later, as my frozen shoulder improved and the pain subsided, I stopped paying attention to it.
Recently, I started to exercise regularly and noticed that during the same arm movement, my right cheek still exhibits noticeable involuntary twitching.
I found that the twitching occurs when I make circles with my left arm.
Is this twitching abnormal? Should I seek medical attention? If so, which specialty should I consult?
For my second question, after walking briskly on a treadmill for about 30 to 60 minutes, I noticed slight swelling and a tingling sensation in my right fingers, while my left hand feels completely normal.
Could this indicate poor blood circulation on the right side, or is there a possibility of embolism? Should I seek further medical evaluation? Thank you for your response!

Joyce, 50~59 year old female. Ask Date: 2021/10/25

Dr. Jiang Junyi reply Neurology

Hello: You mentioned that "the right cheek still has noticeable involuntary twitching.
After testing, it was found that the twitching of the right cheek is triggered by movements involving the left arm," which may indicate a neurological dysfunction affecting the motor area from the spine to the brain.
This can typically be diagnosed using movement-evoked potentials and imaging studies.
You also mentioned "slight swelling and a tingling sensation in the right fingers, while the left hand feels completely normal.
Could this indicate poor blood circulation on the right side? Or is there a possibility of embolism?" This may suggest a problem with peripheral nerve compression.
Clinically, vascular examinations can assist in diagnosing vascular abnormalities.
Symptoms of thrombosis tend to persist longer, and you do not seem to exhibit similar symptoms.
I recommend that you visit a neurology outpatient clinic for further evaluation and follow-up.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to new pandemic prevention measures before and after your medical visit.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital, cares for you.

Reply Date: 2021/10/25

More Info

When it comes to facial twitching and associated symptoms, it is essential to understand the underlying mechanisms and when to seek medical advice. Based on your description, the involuntary twitching of your right cheek during specific arm movements, particularly when you are moving your left arm, could be indicative of a neurological issue. This phenomenon is often referred to as "facial myokymia," which involves involuntary muscle contractions and can be caused by various factors, including nerve irritation or damage.

The fact that you experienced this twitching after a history of shoulder issues, such as frozen shoulder (fifty shoulder), raises a few considerations. While it is possible that the shoulder condition and the associated physical therapy may have contributed to some muscle tension or nerve irritation, the persistence of the twitching during specific movements suggests that it may not be merely a residual effect of your shoulder rehabilitation. Instead, it may warrant further investigation.

In terms of seeking medical advice, it would be prudent to consult a neurologist. A neurologist specializes in disorders of the nervous system and can conduct a thorough evaluation to determine the cause of your facial twitching. This may involve a physical examination, a detailed medical history, and possibly imaging studies or electromyography (EMG) to assess the electrical activity of your muscles and the integrity of the nerves involved.

Regarding your second concern about the swelling and tingling sensation in your right fingers after using a treadmill, this could be indicative of several issues, including potential circulatory problems or nerve compression. The fact that only your right hand is affected raises the possibility of localized issues, such as thoracic outlet syndrome, carpal tunnel syndrome, or even vascular problems affecting blood flow to the right arm.

It is essential to monitor these symptoms closely. If the swelling and tingling persist or worsen, or if you experience additional symptoms such as pain, weakness, or changes in skin color, it would be advisable to seek medical attention. A visit to a vascular specialist or an orthopedic doctor could provide insights into whether there are any underlying circulatory issues or nerve entrapments that need to be addressed.

In summary, both of your concerns—facial twitching during arm movements and the swelling in your right fingers—warrant further evaluation. Consulting a neurologist for the facial twitching and a vascular or orthopedic specialist for the hand symptoms would be the best course of action. Early intervention can often lead to better outcomes, so it is wise to address these symptoms sooner rather than later.

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