Signs of MS Facial Twitching

It might begin as one thing we’re all accustomed to: tiny spasms round your eyelid.

“Once you’re drained or burdened and also you get fluttering beneath your eye or eyelid and it’s actually annoying,” says Sharon Stoll, DO, a neurologist and MS specialist with Yale Medication. And for most individuals, that’s so far as it goes.

However when this twitching is from multiple sclerosis (MS), this facial twitching might unfold. It would go down your cheek to your mouth or jawline. And it occurs extra usually. “It’s occurring a number of instances a day,” says Oliver Tobin, MB, a neurologist who makes a speciality of MS on the Mayo Clinic.

Often, MS facial twitching impacts one facet of your face at a time. And it’s possible you’ll discover different facial signs first, like numbness, tingling, weak spot, or different bizarre sensations.

“Folks will normally say, ‘My face feels swollen, however I look within the mirror and it’s not swollen,’” Stoll says. “And the spasms will occur months later.”

Totally different Varieties of MS Facial Twitching

Even for individuals who have MS, an occasional eyelid tremble, by itself, normally has nothing to do with the illness. However in some circumstances, it is perhaps an indication of a bigger problem associated to MS, together with:

Steady facial myokymia: This may really feel type of like an eyelid twitch (myokymia). However you’ll get ongoing spasms in different areas, reminiscent of your brow, cheek, mouth, and chin.

These twinges are comparatively widespread in individuals who have MS. And so they’re normally short-lived and painless. However they are often uncomfortable. “It simply feels bizarre,” Tobin says.

Hemifacial spasm: In comparison with facial myokymia, these are longer-lasting contractions.

Robust facial spasms might pressure your eyelid closed or pull your mouth to 1 facet. You could really feel quite a lot of tightness, Tobin says. In some unspecified time in the future, all of the muscle groups on one facet of your face could also be concerned. It might seem like you’re having a seizure.

It’s uncommon for MS to trigger hemifacial spasm. Stoll infrequently sees it in her apply. But when it occurs to you, it tends to be extra extreme and lifestyle-limiting than facial myokymia.

“Think about if half your face is spasming on a regular basis,” she says. “You may’t eat. You may’t speak.”

What Causes MS Facial Twitching?

When you’ve MS, your immune system breaks down myelin. That’s the protecting cowl round your nerves. With out this insulation, it’s exhausting for indicators to journey out of your mind to your muscle groups the way in which they need to.

Most individuals with MS facial twitching have a lesion in a sure a part of the brainstem known as the pons. Vital nerves go out and in of this bony canal. Docs usually discover injury to the seventh cranial nerve, higher referred to as the facial nerve.

Just like the title suggests, your facial nerve controls your facial muscle groups. (It additionally performs a component in how a few of your style buds work.)

It’s unclear precisely how MS lesions trigger facial twitching. We’d like extra analysis to seek out out. However scientists have some theories, together with:

Ephaptic transmission: Nerve impulses inform your physique how one can transfer. However an absence of myelin could make your nerves glitchy. And when you’ve two broken (demyelinated) nerves proper subsequent to one another, {the electrical} sign from one can set off the opposite.

“It’s basically like a leaky present,” Tobin says.

Listed here are some examples of ephaptic transmission that you just is perhaps accustomed to:

  • Lhermitte’s signal: You bend your neck and get a buzzing sensation down your physique. It might be an indication of MS, however it may possibly occur to anybody.
  • Tonic spasms: You go to face or transfer your physique and get painful muscle contractions in your arms or legs. These spasms normally final 60 to 90 seconds.

Nerve hyperexcitability: Your facial nerve might hearth greater than it ought to. Some scientists suppose hyperexcitability from different areas might trigger MS facial twitching even for those who don’t have a visual lesion within the pons of your brain stem.

How Do You Diagnose MS Facial Twitching?

In contrast to different MS symptoms, steady facial myokymia and hemifacial spasm will not be an indication of a brand new lesion.

Nonetheless, your physician will need some new photos of your mind to make certain. Up to date MRI scans may give robust clues about whether or not your MS is well-controlled otherwise you’re having a relapse.

You might also get a particular nerve take a look at. That is known as an electromyography (EMG). It’ll measure the timing of your muscle spasms. This can be a good technique to inform the distinction between facial myokymia (quick spasms) and hemifacial spasm (extended spasms).

Your physician might order blood work or further exams to rule out different well being situations. You may have facial twitching for a lot of causes unrelated to MS, together with inflammation or an infection.

Your facial twitches is perhaps idiopathic. Which means “there’s no actual connection” to any medical problem, Stoll says.

Remedy for MS Facial Twitching

You could not must do something besides wait. Facial twitching usually resolves by itself after a number of weeks or months. That’s very true for facial myokymia, Tobin says.

MS-related hemifacial spasm additionally tends to ease over time. However it might take years. And a few folks might have these spasms for the remainder of their life.

The excellent news is you will get assist on your signs regardless of how quick or lengthy they final.

Remedy for MS facial twitching consists of:

Botox: Botulinum toxin can quickly paralyze facial muscle groups. That’s the way it removes wrinkles. Nevertheless it’s additionally the best technique to cease critical facial twitches.

Botox may help folks with hemifacial spasm “get their lives again,” Stoll says.

You’ll usually want pictures each 3 months till your spasms cease. Ask your physician to refer you to a neurologist who frequently treats hemifacial spasm. They’ll assist you determine when it’s protected to start out and cease remedy.

Different drugs: Your physician might have you ever strive different drug remedies. For delicate facial twitching, which may embody

Life-style adjustments: MS facial twitching isn’t your fault. “Nevertheless it’s extra more likely to reappear with stress and fatigue,” Stoll says.

When to See Your Physician

Random eyelid twitches are normally nothing to fret about.

However verify in together with your neurologist if different facial muscle groups begin to spasm. Name them straight away in case your twitches are new and final for greater than 24 hours. “That’s true for any symptom from a number of sclerosis,” Stoll says.

MS facial twitching normally goes away sooner or later. And when that occurs, it’s possible you’ll marvel: Will it come again?

“That’s a superb query. I don’t suppose we actually know,” Tobin says. “But when it’s gone for every week or two, then it’s in all probability gone.”


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