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What Causes Involuntary Twitching Of The Facial Muscles?

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Posted on Sat, 28 Jan 2017
Question: Please see if this question is related to Neurologist. Please read my question.

I am posting this question to a Neurologist. I hope this is the right specialty. If not, please change the specialty according to your decision.

When I am talking, I wont be able to control my facial muscles. This keeps happening sometimes for 4-5 hours in a day & sometimes the whole day. When I am trying to speak something, I wont be able to stretch my mouth according to the requirement (While pronouncing a word. eg. When you are pronouncing the name "Bob", your lips should make a circle to pronounce "Bob". In my case sometimes I wont be able to make a circle while saying "Bob" & I end up pronouncing like "Bab" .. )

I hope you understand my concern. I don't know how to explain.

I often feel like my upper lip sometimes on the right side & sometimes on the left keeps twitching which wont allow me to have a control while speaking. Sometimes it happens for a short duration & sometimes for the whole day. Due to which I am unable to perform well in meetings /presentations. This is making me nervous, anxious.

Pls help.
doctor
Answered by Dr. Sudhir Kumar (11 hours later)
Brief Answer:
Your question is correctly addressed to neurologist.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted your clinical details. Based on this, it seems to be problem related to co-ordination of facial muscles. The common conditions to exclude are 1. Hemifacial spasm, 2. Oro-facial dyskinesias, 3. Tic disorder.

The diagnosis mainly depends on clinical examination. So, if possible, see a neurologist. Also, if you can make short videos of your problem, it would be helpful.

In most cases, there is good benefit from medications. In some cases, botox injection may be needed.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (34 hours later)
Thank you. pls let me know if I can talk to u over the phone. if yes, pls share ur contact number.
I also have to discuss about my other problems. I also consulted a couple of neurologists last year. they were of no help. all they suggested is to stay calm, don't be excited etc. because u know.. this problem which I told u in my main question doesn't happen always. & when it happens, I can't show to the doctor. & when it happens it literally down in confidence levels. because it won't let me speak fluently. I hope u r understanding. that's y asked if I can talk to u over the phone. My other problem is about my tongue. it also won't twist accordingly while speaking. I feel that it's not rotating according to the requirement on how a word is being pronounced. for example.. if u have chilled ice cream, after eating that ur tongue feels like numb, you won't be able to spell correctly. like that it happens.
doctor
Answered by Dr. Sudhir Kumar (3 hours later)
Brief Answer:
You can upload a sample audio of your speech problem.

Detailed Answer:
Thank you for getting back.

As of now, it is not possible to talk over phone. Moreover, when you develop the speech problem, you may be unable to speak to me over me at that exact time.

So, the best option is to make an audio/video of your speech problem, and attach it here. This website allows you to attach videos.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (19 hours later)
Ok. I can understand that you are not available for telephonic conversation. Sure. I will try to make audio /video of this problem.

(1) In the meantime I want to again inform you that I had visited Neurologists in the past. But I dont know how to explain this problem of mine & not sure if they understood. I am also not sure if you are also understanding my problem.

(2) Thats why I also gave an example by telling about how lip movement should be while pronouncing the word "Bob", I end up saying "Bab". I also told you that my tongue wont turn /twist according to the requirement. I also gave an example of a person, after eating chilled ice cream how the tongue wont pronounce words properly /how after boozing a person cannot pronounce words clearly.. it happens like that with my tongue when i am trying to talk.

This has made me feel anxious, depressed. Pls help me.

(3) Atleast acknowledge what you understood from my examples, whats the reason for this problem, is this a severe issue or have you seen these kind of cases in your experience.

(4) Please explain what causes this, whats the treatment.

Please explain to all my points in detail.

doctor
Answered by Dr. Sudhir Kumar (53 minutes later)
Brief Answer:
I have understood your problem.

Detailed Answer:
Thank you for getting back.

I can understand your concern, however, I would like to reassure you that I have understood your problem, and I have seen hundreds of these patients (I work in XXXXXXX which is the the second most populous country in the world and several patients from XXXXXXX and Middle East visit here for treatment). I see about 60 patients per day (six days a week, for the past 23 years).

I already mentioned the possibilities in my first reply- "it seems to be problem related to co-ordination of facial muscles. The common conditions to exclude are 1. Hemifacial spasm, 2. Oro-facial dyskinesias, 3. Tic disorder."

All these problems have good treatments. Once I confirm which of the three you are suffering from, I would tell you about the management in more detail.

Regarding other neurologists not diagnosing it, there are two possibilities. Either they did not understand (therefore, a video helps); or they were not specially trained in treating movement disorders.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (2 hours later)
Thank u for ur kind reply doctor. pls dont mind as i narrated all these examples again. i was just trying to make sure i explain in detail so that it will be easy for u to understand. as u know like one will surely be confused on how to explain these things as the symptoms are not easy to track /explain.

I am happy that you have understood my case. thnks for your acknowledging. so kind of u. i will surely meet a Neurologist & will discuss with him by keeping this discussiion as reference & your advice as my bible to explain more efficiently to the Neurologist. you have really given me the hope that this can be treated.

thanks again
doctor
Answered by Dr. Sudhir Kumar (2 hours later)
Brief Answer:
My pleasure to be of help to you.

Detailed Answer:
Thank you for getting back.

I did not mind at all. In fact, I would be privileged, if my opinion helps you get a correct diagnosis and correct treatment.

Please keep me informed of your progress.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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What Causes Involuntary Twitching Of The Facial Muscles?

Brief Answer: Your question is correctly addressed to neurologist. Detailed Answer: Thank you for posting your query. I am Dr Sudhir Kumar, Neurologist, and would try my best to help you. I have noted your clinical details. Based on this, it seems to be problem related to co-ordination of facial muscles. The common conditions to exclude are 1. Hemifacial spasm, 2. Oro-facial dyskinesias, 3. Tic disorder. The diagnosis mainly depends on clinical examination. So, if possible, see a neurologist. Also, if you can make short videos of your problem, it would be helpful. In most cases, there is good benefit from medications. In some cases, botox injection may be needed. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX XXXXXXX Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in