What to do if facial muscle twitches?

Uncontrolled twitching of facial muscles may not be life-threatening, but it can often make people feel embarrassed. There are many reasons for facial twitching, including localized epilepsy or facial nerve disease. At first, only the eyelids may twitch slightly, and then the corners of the mouth will slowly twitch. It will be particularly obvious when there are many people around, so it will increase the patient's psychological burden and make the patient feel nervous. The more this happens, the more obvious the twitching will be. It can be relieved or even treated by taking medication or physical therapy.

Facial muscle twitching and hemifacial spasm are paroxysmal involuntary twitching of half-side facial muscles and eyelids. Although they are not life-threatening, repeated facial muscle twitching often makes people feel embarrassed. There are many causes of hemifacial spasm. It can be one of the sequelae of facial nerve paralysis, or it can be caused by lesions of the intracranial facial nerve motor nucleus or facial nerve. It may also be a manifestation of localized epilepsy caused by lesions in the motor area of ​​the cerebral cortex. But in more cases, no obvious cause can be found, which is called primary hemifacial spasm. Primary hemifacial spasm mostly occurs in adult women. Initially, it may only be a slight twitching of the upper or lower eyelids or corners of the mouth, which may later extend to other muscles on the same side of the face. Episodic twitching of the corners of the mouth or eyelids is most noticeable. The patient's convulsions are most obvious in public situations such as conversations and reports. Therefore, whenever the patient interacts with others, his emotions will become nervous due to fear of convulsions. The more nervous he is, the more obvious the convulsions will be, and the heavier the mental burden will be.

The following are some of the main treatment methods.

(1) Drug treatment: such as diazepam, luminal, carbamazepine, and phenytoin sodium can alleviate symptoms in a small number of patients. Muscle relaxants such as chlorzoxazone also have some effect.

(2) Physical therapy: such as calcium ion infusion therapy, horizontal electrical stimulation, radiofrequency thermocoagulation therapy, etc.

(3) Ethanol injection therapy: For cases where the above-mentioned drugs or physical therapy are ineffective and the symptoms are severe, ethanol injection therapy may be considered. Injecting different concentrations of ethanol up to anhydrous ethanol into the nerve trunk can temporarily interrupt the conduction function of the facial nerve and relieve facial muscle spasm.

(4) Botulinum toxin type A injection therapy: Botulinum toxin type A is injected into the facial motor nerve endings to produce muscle relaxation paralysis, thereby relieving spasms. After the injection, the spasms were relieved rapidly in the short term, and no side effects were found in those who received repeated injections.

(5) Triple injection therapy: This is the treatment for hemifacial spasm that the author uses in practice. The main method is to inject hormones, diazepam, and other drugs into the stylomastoid foramen, the midpoint of the preauricular fold, and facial motor points according to the patient's specific situation, thereby effectively relieving hemifacial spasm. The advantages of this method are: simple and easy, painless treatment, patients are willing to accept, small local side effects, and no allergic reactions to repeated injections.