Symptoms and Causes of Facial Twitching

When discussing facial twitching, we are really dealing with a symptom of facial paralysis as opposed to a condition. That is, facial twitching is itself the result of an injury or disorder involving the facial nerve. Facial twitching can be a symptom of Bell's Palsy, hemifacial spasm, a vascular lesion, or a simple tic disorder. To properly diagnose the cause will require a patient history and diagnostic testing.

Facial twitching can present due to a number of underlying causes. Irritation of the facial nerve is the direct cause of facial twitch. It then becomes necessary to determine the cause of the irritation or injury to the facial nerve. Facial twitching, or spasm, originating in the eye area could point to hemifacial spasm.

Depending on factors such as patient history, which specific facial muscles are twitching, and whether there are other associated symptoms, the underlying cause could be many things including:

  • Multiple sclerosis
  • Dystonia
  • Tourette syndrome
  • Tumor
  • Lesion causing pressure to the facial nerve

Facial Twitching Treatment

As facial twitching is a symptom of an underlying cause, treatment then is directed to the cause of the twitching. Diagnostic imaging may be performed to rule out the presence of a tumor or lesion irritating the nerve.

A comprehensive approach to treatment is essential to effect the most satisfactory results with the least risk of undesirable side effects and as minimally invasive as possible. To that end, treatment typically begins with medical treatment, such as antiviral drugs, pain medication and/or steroids to reduce inflammation of the affected nerve. Physical therapy may be useful in helping the patient control the twitching. Botulinum toxin is also used to quell the movement of muscles.

If the condition does not improve with medical treatment and therapy, surgical treatment may be necessary, such as microvascular decompression to relieve pressure on the nerve.

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