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Twitching in the face

definition

For us, the face is the gateway to the social environment. The first glance usually goes into the face of our counterpart, which is why the majority of people attach great importance to the health and care of the face.

If it comes to "irregularities" in the face, this is often immediately visible to everyone. This can be a burden on the affected person. Also twitching is an undesirable conspicuousness that can disturb or irritate both the person affected, as well as the person opposite.

Muscle twitching is referred to in the jargon as myoclonus or as fasciculations. When twitching occurs in the face, it can have different causes. The spectrum ranges from emotional states, through the effects of various substances, to serious illnesses. Although usually a trivial origin of muscle twitching is to be expected, certain diseases should be excluded by the specialist in recognizable regularity.

causes

Before you worry about serious diseases, it should be clear beforehand: twitching in the face can be triggered by trifles. For some people stress at work and "the eye gets nervous" by twitching the lid.

Overall, emotionally charged states favor the appearance of such phenomena. Even too little sleep or a slight magnesium or potassium deficiency can cause such symptoms - which usually go back again.

While muscle twitching can occur naturally under tension or during the fall asleep, there are also some neurological diseases whose clinical picture is characterized by involuntary twitching. Rarely, only the face is affected, but epilepsy, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and encephalitis should be ruled out in case of recurring (long-lasting, disturbing) twitching of the face.

Furthermore, a hemifacial spasm may underlie. This is an irritation of the facial nerve, which is responsible for the mimic muscles (facial nerve). However, this is a rather rare disease.

Muscle twitching is far more often associated with a so-called tic disorder, which is a disease in the field of neurology and psychiatry. Again and again, patients compulsively repeat a certain movement or utterance, which is usually triggered by certain triggers. Particularly well-known here is the Tourette syndrome.

The intake of medication and other substances can cause twitching in the face. Antipsychotics (or neuroleptics) find their use mainly in schizophrenia, mania and psychotic delusional or arousal states. In particular, the typical neuroleptics (eg Haloperidol®, Chlorpromazin®, Melperon®) cause extrapyramidal motor disorders, which can manifest in muscle twitching of the face.

Excessive alcohol consumption and illicit drugs can also cause facial twitching.

Jerks by drugs

In principle, a variety of drugs can cause muscle twitching or cramping. In particular, the activating substances such as amphetamine (speed), MDMA (ecstasy), cocaine or methamphetamine (crystal meth) lead to an increased need for movement. This activation may exceed the controlled movements and then trigger involuntary twitching in the face and other muscles of the body.

Another possibility is that the twitches occur after consumption. On the one hand, the activation of the body and, on the other hand, an electrolyte system brought out of equilibrium are the basis. Increased exercise causes consumers to sweat, causing them to lose electrolytes, and muscles become overused. These react either with convulsions or with an over-excitability. Excessive consumption of cocaine and heroin also causes severe nerve and muscle cell damage.

In general, any medication or substance abuse can cause serious harm and death. Please seek medical help if this applies to you.

The influence of alcohol

In addition to illegal drugs, alcohol can cause facial twitching. Although it is valued in our society as a stimulant, it should not be underestimated that alcohol is also addictive and can seriously damage the body and psyche.

On the one hand there is the acute alcohol intoxication - the poisoning with alcohol after excessive consumption. In addition to nausea, vomiting and loss of consciousness synonymous muscle twitching may occur. These are caused by spontaneous activation due to alcohol poisoning. The twitches usually stop as soon as the acute condition is overcome.

On the other hand, there is the systematic alcohol abuse for years. Alcohol is a neurotoxin, which attacks and destroys the nerve cells in the body in the long term. It comes to a so-called denervation. This results in a spontaneous activation of the muscle cells, because the limiting factor of the nerves is eliminated. The twitches can then also occur permanently, as the tissue was irretrievably damaged.

Twitches in multiple sclerosis

Multiple sclerosis is a disease in which the insulating sheath of the nerve cords is damaged by the body's immune system. This leads to over excitability or failure of these nerves.

In most cases, the disease is in spurts, with some of the symptoms usually regressing over a period of time. Many patients report twitching in the face during a nudge. These can often be considered as a first sign of impending deterioration, as small nerve fibers are responsible for movement (and can be triggered more quickly in arousal). Especially often the eyelid seems to be affected.

In addition or in isolation, the corner of the mouth can twitch. In principle, these movements are possible on all facial muscles, but they are particularly noticeable on the eye or mouth of the affected person, since they can disturb or interfere with interpersonal communication.

You might also be interested in: eyebrow twitching, blinking - what to do?

Can this be an indication of epilepsy?

In fact, twitching of the face may be due to epilepsy. In particular, if the twitching recurring occur and accompanied by twitching of other parts of the body, an epilepsy is all the more likely. Although such types of epilepsy are not usually dangerous, a neurologist should be consulted on such conditions. Although an unequivocal diagnosis of epilepsy is not always possible, the expert on the basis of the symptom picture and with the aid of apparatus examinations (especially EEG) can usually estimate very well whether epilepsy is present or other causes are more probable. If necessary, he may also initiate an antiepileptic therapy, which can reduce the twitches usually relatively quickly and effectively or even eliminate completely.

Stress as a trigger of facial twitching

Stress can have a variety of consequences on the body. Different systems play crazy in prolonged stress situations. When everyday life is emotionally distressing, it has an impact on sleep, hormones, mood and many other aspects.

Here, twitching in the face can be an expression of such an emotional imbalance. A morbid cause can not be found in the rule. Often, especially young people present themselves to neurologists because of such symptoms because they have read or heard of serious illnesses that may be associated with muscle twitching.

However, even after a short diagnosis, it turns out that it is not a disease but the existing stress situation that is responsible for the involuntary movements. Stress can be triggered by anything that emotionally upsets the patient: a breakup, quarrel, work, pressure to perform, or the loss of a loved one.
Therapy consists in coping with personal problems, possibly in combination with a talk therapy, and learning stress management techniques (eg, meditation, yoga, or the like).

This could also interest you: How can I reduce stress?

Twitching of the face with nervousness

Nervousness is a reaction of the nervous system. This responds to a stressful situation, which in memory is associated with negative experiences. Nervousness can occur in the normal context, eg in the second attempt after a failed exam. Almost every person knows the feeling of nervousness and can remember corresponding situations.

Some people with psychiatric or mental illness are confronted with such situations on a daily basis. It's all about anxious personality disorder and social phobia. In both diseases, the contact with other people and, above all, strangers is a major problem. The fear of doing or saying something wrong is extremely high.

The fear and uncertainty are expressed, for example, in twitching in the face. These are again perceived as unpleasant and therefore lead to further avoidance behavior - a vicious circle for those affected. Often a psychological or psychiatric treatment (eg, talk therapy) can help to productively deal with the fears and bring about an improvement.

What influence does the psyche have on twitching in the face?

Twitching in the face can also be caused solely by the psyche of the person concerned. Everyone reacts differently to excitement, stress, joy and suffering. While some people express their emotions on an emotional level, others have their minds on the body. Exactly such extreme emotional states can lead to twitching of the face, which then expresses the emotional state of stress.

Very small muscle twitches or fasciculations occur on the eyelid. These can last for different lengths, but usually dissipate after conscious emotional relaxation.
The fear of twitching can in turn increase the symptom.

treatment

  • If the twitching is due to a lack of specific nutrients, the therapy is relatively easy. The person concerned should focus on a conscious and balanced diet. It can help against magnesium deficiency, especially products with sunflower or pumpkin seeds. Also potassium-rich food such as potato dishes or avocado can lead to an improvement of the deficiency situation. Sodium can be easily supplied by sufficient salting of the food. If adequate nutritional intake can not be guaranteed, dietary supplements may also be used.
  • If the twitches are of psychological origin and can be attributed to stress or an emotionally stressful situation, relaxation can help. Everybody should plan a daytime time for their own person, in which one does not let themselves be distracted by anything or anyone. Restful and sufficient sleep can also relieve tension - whether of a physical or emotional nature.
  • If a neurological disorder is underlying, a doctor should prescribe appropriate medication. For diagnosed epilepsy, these would be, for example, anticonvulsants (anticonvulsants) such as Lamotrigin® or Valproat®. The drugs dampen the excitability of the nervous system and thus the excitement of the muscles. In MS, one works with cortisone and other immune modulators (drugs affecting the immune system).
  • If the twitching in the face is a symptom of poisoning, it is important to treat it specifically with detoxifying measures.
  • If the muscle twitches can not be limited by the described treatment measures, there is still the possibility of Botox injection. Botox (botulinum toxin) is a neurotoxin that is also used as part of beauty procedures. When injected, it paralyzes the muscle by inactivating the responsible nerve.

symptoms

The symptoms are the smallest muscle contractions on the face. These can occur on different parts of the facial muscles, but are mainly concentrated on the mouth and eye area. Especially twitching occurs on the eyelid. Those affected describe the twitching as trembling or fluttering of the lid.
If twitching on the face lasts longer, it can also lead to headaches for those affected. They try to suppress the involuntary movement and are therefore tense.

Muscle twitching can be a symptom of various neurological diseases or occur in the context of an emotional stress situation. In both cases, the uncontrollable state usually has a negative effect on the mind of the affected person - resulting in a depressed mood.

diagnosis

When twitching in the face is a gaze diagnosis, ie the doctor sees at first glance, which symptom the patient leads to him. The extent of muscle twitching gives indications as to whether it is actually only fasciculations of individual muscle fiber bundles or movement disorders.

The latter can be caused, for example, by longer-term use of antipsychotics / neuroleptics. Whether it is a harmless muscle twitch or if it occurs as part of an existing nerve damage, can be detected by an EMG.

In EMG, which means electromyography, small needle electrodes are pierced into the muscle to be examined in order to derive its electrical voltage differences. From these can then be concluded on the activity of the muscle.

If the EMG shows abnormalities, it seems likely that there is nerve damage.

Twitching in the mouth area

Twitching in the mouth is most likely to affect the tongue or the corners of the mouth and occur psychologically (by the psyche), by substance abuse or medication. The tongue is a dense construct of muscle and therefore sensitive to the smallest neuronal damage. While the smallest muscle twitches in other parts of the body can not be perceived by the naked eye, but can only be seen in the EMG, they can be seen in the tongue.

Even stronger twitches are an indication of nerve damage. There is a possibility that damage to the responsible cranial nerve (hypoglossal nerve) is responsible for the symptoms. This controls the entire tongue muscles, so that in case of a nerve damage twitching or even paralysis can occur.

A beginning ALS (Amyotrophic Lateral Sclerosis) may also be noticeable in the beginning due to twitching of the tongue. Since this is a very serious nerve disease, a doctor should always be consulted if suspected.

How long do the twitches last?

A twitch in itself takes only a fraction of a second. As soon as the "twitching" lasts longer, it is a convulsion, which has other causes. Frequently, fasciculations occur in rapid repetition one after the other. The series can last only a few minutes, but also for hours.

The longer the twitching in the face, the more stressful the condition becomes for the person concerned. Often fasciculations occur again and again, even if they are not based on any neuronal disease. However, if the duration exceeds the individual tolerance, do not be afraid to go to a doctor's office and seek professional help. Perhaps the specialist can detect and detect emotional problems that were previously hidden or not associated with the symptom.

Twitching of the face in children

When twitching of the face occurs in children, the number of possible or probable causes is considerably reduced: Alcohol and drugs are generally out of the question, drugs also much less common than in adults - although of course some children have to take medication and In addition, it has already come to cases in which just toddlers have plundered the drugs of their parents and kept for sweets. Mental stress, hemifacial spasm and multiple sclerosis, which are among the most common causes of facial twitching in adults, are also very unlikely in children.

If the convulsions recur again and take an intolerable extent, this should nevertheless be clarified by a doctor. Because especially for children, it can be particularly stressful if they are perceived by other children as "strange" because of their twitching and thus become outsiders. As a rule, no dramatic causes of the twitching can be found, occasionally an epilepsy can be detected. In most cases, however, this can be treated effectively with an anticonvulsant, which also reduces or completely eliminates facial twitching. Of course, it must be ensured that a drug suitable for children is selected. These include carbamazepine, valproate and lamotrigine.

Twitching of the face and headache

If the twitching of the face persists over a long period of time, many people develop headaches over time. This is usually because the sufferers are tense about the unpleasant twitches when trying to suppress them. If this is the case, relaxation and loosening exercises of the facial muscles can provide relief - even if admittedly they can look strange at times.

Of course, if the headache is too severe and you need a quick relief, you can of course take a painkiller, but this should not be a habit. Instead, a doctor should be consulted for longer-lasting such complaints better. He may be able to prescribe medications to relieve the spasms, breaking the cycle of twitching and headache.

Twitching of the face after a stroke

Patients in the recovery and rehabilitation phase after a stroke experience significantly more facial twitching than the average general population. This is usually the case in patients whose face is also affected by the effects of stroke, such as deafness or paralysis. The accumulation of twitches after a stroke is probably due to healing and restructuring processes in the brain, in which some parts of dead nerve fibers regain a certain degree of functional efficiency, or connections between nerve tracts are redesigned. In this sense, the twitching of the face after a stroke is usually not a cause for concern, but rather even a positive sign and expression of a progressive healing.

Is this a tic?

This is in a sense a definition question. In a broader sense, the term Tic describes sudden, largely involuntary short expressions or movements of individual muscles or entire body parts, so that twitching of the face also falls under this category. In general, however, such phenomena are only referred to as Tic if they can be suppressed over a more or less long period of time until the internal tension becomes too strong.

This is much more often the case with tics such as certain finger movements, winking or frowning. As a rule, twitching of the face is not preceded by inner compulsion, it usually takes place completely unannounced and sometimes even without the affected person noticing it. In summary, it can be said that twitching in the face, by definition, by all means counts as tic, but in the narrower sense this term is reserved for other phenomena.

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