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Severe facial twitching, also known as facial muscle spasms or facial dystonia, can be a distressing and disruptive condition that significantly impacts a person’s quality of life. It involves involuntary and repetitive contractions of facial muscles, leading to facial distortions and discomfort. Understanding the potential causes and available treatments for severe facial twitching is crucial for those affected by this condition.

Causes of Severe Facial Twitching

There are many possible causes of facial twitching. It is not a condition by itself but a symptom of an underlying health problem. Some of the common causes of severe or chronic facial twitching include:

  • Hemifacial Spasm: Hemifacial spasm is a neurological disorder characterized by involuntary spasms or contractions on one side of the face. It is often caused by irritation or compression of the facial nerve, typically due to a blood vessel pressing on the nerve.
  • Blepharospasm: Blepharospasm is a type of dystonia that primarily affects the muscles around the eyes, causing uncontrolled and excessive blinking and eye closure. The exact cause is unknown, but it is thought to involve abnormal brain activity.
  • Idiopathic Facial Dystonia: In some cases, severe facial twitching may be classified as idiopathic, meaning the cause is unknown. This form of facial dystonia can manifest as involuntary muscle movements, contractions, or spasms in various areas of the face.
  • Medications: Certain medications or their side effects can lead to facial twitching. This includes antipsychotic drugs, antiemetics, and some stimulants.
  • Neurological Conditions: Underlying neurological conditions such as Bell’s Palsy, multiple sclerosis, Parkinson’s disease, or Tourette syndrome may present with facial twitching as a symptom.

Treatments for Severe Facial Twitching

Treatment for facial twitching can include therapies for the condition causing the muscle spasms. If these are ineffective, treatment of the symptom may be recommended to provide relief.

  • Botulinum Toxin (Botox) Injections: Botulinum toxin injections are a commonly used and effective treatment for severe facial twitching. Botox injections work by temporarily paralyzing the overactive muscles responsible for the twitching. The effects typically last a few months, and repeat injections are necessary to maintain relief.
  • Medications: Certain medications, such as anticholinergics, muscle relaxants, and anti-seizure drugs, may be prescribed to help manage severe facial twitching. These medications can reduce muscle contractions and provide relief.
  • Surgery: In cases of hemifacial spasm or other severe facial twitching conditions with an identifiable structural cause, surgical intervention may be considered. Microvascular decompression surgery involves repositioning or removing the blood vessel pressing on the facial nerve.
  • Physical Therapy: Physical therapy techniques, including massage, stretching, and exercises, can be beneficial in managing severe facial twitching. These methods can help relax and strengthen the facial muscles.
  • Stress Management: For individuals whose facial twitching is exacerbated by stress or anxiety, stress management techniques such as mindfulness meditation, relaxation exercises, or psychotherapy may help reduce the frequency and severity of spasms.
  • Lifestyle Modifications: Identifying and avoiding triggers that worsen facial twitching, such as caffeine, alcohol, or fatigue, can be an essential part of managing the condition.

While severe facial twitching can be a disruptive and distressing condition, many treatment options are available to relieve and improve the quality of life for those affected. Early intervention and a multidisciplinary approach, including medications, injections, therapy, and lifestyle modifications, can help individuals manage their symptoms effectively. If you are experiencing facial twitching, contact our experienced team at New York Facial Paralysis to schedule an exam and consultation with one of our specialists.

Posted on behalf of New York Facial Paralysis

Grand Park Building, 110 East 40 Street, Suite 501
New York, NY 10016

Phone: (212) 434-4050

FAX: (212) 434-4059


Monday - Friday: 8:30 AM – 5:00 PM



New York Facial Paralysis

At Manhattan Eye, Ear, and Throat Hospital

Grand Park Building, 110 East 40 Street, Suite 501
New York, NY 10016

(212) 434-4050 (212) 371-3223 (FACE)

Opening Times: Monday - Friday: 8:30 AM – 5:00 PM

If you are interested in discussing your case with the NYFP specialists: