Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Left-sided Twitching On Face And Eye?
Question: My face an eye are twitching on the left side of my face. I had a doctor suggest that it might be neurological or maybe Vit B and Mag deficiency. I started to take some Vit B and Mag but they seemed to effect my kidneys. Any suggestions?
Brief Answer:
It seems to be Hemifacial spasm based on your history.
Detailed Answer:
Hi XXXXXXX
Thanks for being on Healthcaremagic.
I'm Dr.Ajay Panwar, a neurologist and I'd surely help you with your query.Your complaints most likely point to the clinical diagnosis of 'Hemifacial spasm'. Since you are 55 years old,this age of onset(if it is of recent onset) also favours 'Hemifacial spasm' as your diagnosis.However,some other etiologies which uncommonly may result in a similar clinical picture are-Tics and focal seizures.
I would like to know certain additional details to get closer to your diagnosis:
1)At what age it started ?
2)Did it started first in the periorbital muscles(eye) or the facial muscles?
3)Does the twitching occurs simultaneously in face as well as eye?(or is it like when eye twitch occurs, face is at rest and vice versa.)
4)Does it occurs sometimes on the opposite side of the face also?
5)Does it persist during sleep?
6)Can you voluntarily suppress it if you want to?
7)Do you have any history of seizures,or involuntary jerky movements of limbs?
8)Do you have any other past medical history like Diabetes,Hypertension or any other illness?
9)Did you ever had any surgical history?
Lastly,I suggest that if you can make a short video clip and if it can be uploaded here,it will be of great help in diagnosing and guiding further management.
I hope to see you soon in follow up with the details I asked.Good bye till then.
Dr.Ajay Panwar
MD,DM(Neurology)
It seems to be Hemifacial spasm based on your history.
Detailed Answer:
Hi XXXXXXX
Thanks for being on Healthcaremagic.
I'm Dr.Ajay Panwar, a neurologist and I'd surely help you with your query.Your complaints most likely point to the clinical diagnosis of 'Hemifacial spasm'. Since you are 55 years old,this age of onset(if it is of recent onset) also favours 'Hemifacial spasm' as your diagnosis.However,some other etiologies which uncommonly may result in a similar clinical picture are-Tics and focal seizures.
I would like to know certain additional details to get closer to your diagnosis:
1)At what age it started ?
2)Did it started first in the periorbital muscles(eye) or the facial muscles?
3)Does the twitching occurs simultaneously in face as well as eye?(or is it like when eye twitch occurs, face is at rest and vice versa.)
4)Does it occurs sometimes on the opposite side of the face also?
5)Does it persist during sleep?
6)Can you voluntarily suppress it if you want to?
7)Do you have any history of seizures,or involuntary jerky movements of limbs?
8)Do you have any other past medical history like Diabetes,Hypertension or any other illness?
9)Did you ever had any surgical history?
Lastly,I suggest that if you can make a short video clip and if it can be uploaded here,it will be of great help in diagnosing and guiding further management.
I hope to see you soon in follow up with the details I asked.Good bye till then.
Dr.Ajay Panwar
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Prasad
1. At what age it started? It started about 2 months ago. I am 55.
2. Does the twitching occur simultaneously in the face and the eye? Yes.
3. Does it occur sometimes on the opposite side of the face. No.
4. Does it persist in your sleep? No.
5. Can you voluntarilly suppress it, when you want to? No.
6. Do you have a history of seizures or involuntary jerky movements? No.
7. Do you have any past medical history like Diabetes, Hypertension or other illness? No. I am in good health, 6 feet 1 inch, 195 pounds, no medications.
8. Sergical history. None.
2. Does the twitching occur simultaneously in the face and the eye? Yes.
3. Does it occur sometimes on the opposite side of the face. No.
4. Does it persist in your sleep? No.
5. Can you voluntarilly suppress it, when you want to? No.
6. Do you have a history of seizures or involuntary jerky movements? No.
7. Do you have any past medical history like Diabetes, Hypertension or other illness? No. I am in good health, 6 feet 1 inch, 195 pounds, no medications.
8. Sergical history. None.
Brief Answer:
It is Hemifacial spasm.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
Your entire clinical history makes Hemifacial spasm as your clinical diagnosis.
Plan of management:
1)Brain imaging-You need to get to a neurologist so that he may assess you for the need of a Magnetic resonance imaging(MRI) of Brain to see for facial nerve root entry zone compression at the brainstem by an aberrant brain vessel (Hemifacial spasm is primary in most of the cases but vascular compression of facial nerve is sometimes a secondary cause and if detected so,it is to be treated surgically).
2)Medication-Initial therapy of choice is usually,carbamazepine which is an anticonvulsant but has been documented to be effective in aborting symptoms in about 70% of the cases of Hemifacial spasm.Other medications may include Benzodiazepines like clonazepam and anticholinergics like trihexyphenidyl.Please consult your neurologist for the medication plan suitable to you.
3)Botulinum toxin- If patient does not respond to medicines,botulinum toxin injections in facial and periorbital muscles is a very effective strategy(effect lasts for 3 to 4 months and thereafter injections are repeated again).
It is neurological and vitamins( or minerals) will not help it.If you have any further questions,I shall be glad to revert,else you can close the thread and rate it.
If you want to,you can also send me a direct query at my link-
http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273
Dr.Ajay Panwar
MD,DM(Neurology)
It is Hemifacial spasm.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
Your entire clinical history makes Hemifacial spasm as your clinical diagnosis.
Plan of management:
1)Brain imaging-You need to get to a neurologist so that he may assess you for the need of a Magnetic resonance imaging(MRI) of Brain to see for facial nerve root entry zone compression at the brainstem by an aberrant brain vessel (Hemifacial spasm is primary in most of the cases but vascular compression of facial nerve is sometimes a secondary cause and if detected so,it is to be treated surgically).
2)Medication-Initial therapy of choice is usually,carbamazepine which is an anticonvulsant but has been documented to be effective in aborting symptoms in about 70% of the cases of Hemifacial spasm.Other medications may include Benzodiazepines like clonazepam and anticholinergics like trihexyphenidyl.Please consult your neurologist for the medication plan suitable to you.
3)Botulinum toxin- If patient does not respond to medicines,botulinum toxin injections in facial and periorbital muscles is a very effective strategy(effect lasts for 3 to 4 months and thereafter injections are repeated again).
It is neurological and vitamins( or minerals) will not help it.If you have any further questions,I shall be glad to revert,else you can close the thread and rate it.
If you want to,you can also send me a direct query at my link-
http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273
Dr.Ajay Panwar
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks for your reply. I will follow up by visiting the neurologist. I will also mention that someone suggested checking for diabetes.
I should mention that I have muscle twitches spasms in my left arm (bicep) and tingling in my feet.
I should mention that I have muscle twitches spasms in my left arm (bicep) and tingling in my feet.
Brief Answer:
Arm muscle twitches may be associated or just benign fasciculations.
Detailed Answer:
Hi XXXX,
I Dr.Ajay Panwar,welcome you for the day.
Thanks for being in follow-up.
Regarding your query, Hemifacial spasm is not seen to be associated clinically with Diabetes.However, frequent screening of blood sugar as the age advances is a good health practice.
Muscle twitches in left arm may be associated with Hemifacial spasm.Hemifacial spasm is a form of segmental myoclonus and sometimes it may be associated with segmental myoclonus in the other body parts, in addition to face.Alternatively,arm muscle twitches may just be benign fasciculations. However,their significance can only be established once a neurologist examine you in detail regarding your individual muscle strength and tendon reflexes.
'Tingling in feet' needs a little more history to make any impression-Is it persistent or intermittent?If intermittent,what is the frequency?Since how many days,weeks or months you are having this complaint?Is it associated with pain?Did you ever had any complaint in gripping footwear while walking? Tingling however, can be a manifestation of vitamin deficiency and may be an early feature of peripheral neuropathy(of which Diabetes may be a cause).
Hope I have answered your queries.If you still have follow-up questions,I shall be glad to help you else,you can close the thread and rate it.If you liked the reply,please write a review.If anytime in future you want to send a query directly to me,here is my HCM link-
http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273
Dr.Ajay Panwar
MD,DM(Neurology)
Arm muscle twitches may be associated or just benign fasciculations.
Detailed Answer:
Hi XXXX,
I Dr.Ajay Panwar,welcome you for the day.
Thanks for being in follow-up.
Regarding your query, Hemifacial spasm is not seen to be associated clinically with Diabetes.However, frequent screening of blood sugar as the age advances is a good health practice.
Muscle twitches in left arm may be associated with Hemifacial spasm.Hemifacial spasm is a form of segmental myoclonus and sometimes it may be associated with segmental myoclonus in the other body parts, in addition to face.Alternatively,arm muscle twitches may just be benign fasciculations. However,their significance can only be established once a neurologist examine you in detail regarding your individual muscle strength and tendon reflexes.
'Tingling in feet' needs a little more history to make any impression-Is it persistent or intermittent?If intermittent,what is the frequency?Since how many days,weeks or months you are having this complaint?Is it associated with pain?Did you ever had any complaint in gripping footwear while walking? Tingling however, can be a manifestation of vitamin deficiency and may be an early feature of peripheral neuropathy(of which Diabetes may be a cause).
Hope I have answered your queries.If you still have follow-up questions,I shall be glad to help you else,you can close the thread and rate it.If you liked the reply,please write a review.If anytime in future you want to send a query directly to me,here is my HCM link-
http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273
Dr.Ajay Panwar
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
