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What Causes Sudden Hemifacial Spasms?
Question: My mother around 60 years old is having hemifacial spasm for the last two years. It started as eye twitching and gradually the left side till the lips. It is not continuous and only happens along with excess emotions like laughing, talking aggressively etc.
She consulted a doctor who prescribed pacitane and ethizola after which in 2 months is was gone. It again started after 6 months in times of general tension or anxiety at home. Again it stopped in sometime when things stabilized.
So this is not continuous, comes in for 1 to 2 months in between stops for a few months then would again come up suddenly. The doctor has suggested some botox injections but my mother doenst want to go for it. Is there any other remedy that could be checked out.
PS: She is taking medicines like ecosprin, BP medicines and for cholesterol
She consulted a doctor who prescribed pacitane and ethizola after which in 2 months is was gone. It again started after 6 months in times of general tension or anxiety at home. Again it stopped in sometime when things stabilized.
So this is not continuous, comes in for 1 to 2 months in between stops for a few months then would again come up suddenly. The doctor has suggested some botox injections but my mother doenst want to go for it. Is there any other remedy that could be checked out.
PS: She is taking medicines like ecosprin, BP medicines and for cholesterol
Brief Answer:
Get done vitamin b 12 level.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your mother's situation and problem.
This kind of sudden hemifacial spasm are seen due to nervous hyperstimulation.
Vitamin b 12 deficiency can also trigger it.
So get done vitamin b 12 level and if Deficiency than she needs supplements.
Combination of vitamin b 12 and pregabalin is also recommended.
Please let me know
1. Has she ever consulted psychiatrist for stress and anxiety management?
2. Has she ever undergone vitamin b 12 level?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Get done vitamin b 12 level.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your mother's situation and problem.
This kind of sudden hemifacial spasm are seen due to nervous hyperstimulation.
Vitamin b 12 deficiency can also trigger it.
So get done vitamin b 12 level and if Deficiency than she needs supplements.
Combination of vitamin b 12 and pregabalin is also recommended.
Please let me know
1. Has she ever consulted psychiatrist for stress and anxiety management?
2. Has she ever undergone vitamin b 12 level?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by :
Dr. Yogesh D
1. She has not consulted psychiatrist but is prescribed ethizola to be taken on need basis during such spasms by the physician.
2. Vitamin b12 level test has not been done yet.
2. Vitamin b12 level test has not been done yet.
Brief Answer:
Get done vitamin b 12 level.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So in my opinion, you should first get done vitamin b 12 level.
And start combination of vitamin b 12 and pregabalin.
Also consult psychiatrist and get done counselling sessions. Try to identify stressor in her life and start working on its solution.
She may need regular drugs to prevent such emotional spike and associated symptoms.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.
Get done vitamin b 12 level.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So in my opinion, you should first get done vitamin b 12 level.
And start combination of vitamin b 12 and pregabalin.
Also consult psychiatrist and get done counselling sessions. Try to identify stressor in her life and start working on its solution.
She may need regular drugs to prevent such emotional spike and associated symptoms.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sure; will get Vitamin B12 done.
Wanted to confirm it is not related to any neurological problems and is mainly anxiety related? And do botox injections really help in stopping the spasms?
Wanted to confirm it is not related to any neurological problems and is mainly anxiety related? And do botox injections really help in stopping the spasms?
Brief Answer:
No I don't think botox injections will help in this.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern. I don't think botox injections will help in this case.
Looks like stress and anxiety related symptoms is more likely.
But we can not deny the possibility of neurological disease because facial nerve disease can cause similar symptoms.
To rule out this, EMG (electro myelo graphy) with NCV (nerve conduction velocity) are needed.
So please let me know, EMG NCV study was done or not?
I will be happy to help you further. Wishing good health to your mother. Thanks.
No I don't think botox injections will help in this.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern. I don't think botox injections will help in this case.
Looks like stress and anxiety related symptoms is more likely.
But we can not deny the possibility of neurological disease because facial nerve disease can cause similar symptoms.
To rule out this, EMG (electro myelo graphy) with NCV (nerve conduction velocity) are needed.
So please let me know, EMG NCV study was done or not?
I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
EMG and NCV was not done. My mother is not willing to go for any tests as she is already taking many medicines. Will be difficult to convince her for these.
What is the facial nerve disease and what causes it? If it is just intermittent spasms that stop in between for 2 3 months together...would that be a disease.
I mean if the possibility of the nerve disease is relatively low based on the symptoms, I would prefer not to force her to go for these extensive tests.
Please guide.
Will get a psychiatric evaluation done and B12 test done immediately.
What is the facial nerve disease and what causes it? If it is just intermittent spasms that stop in between for 2 3 months together...would that be a disease.
I mean if the possibility of the nerve disease is relatively low based on the symptoms, I would prefer not to force her to go for these extensive tests.
Please guide.
Will get a psychiatric evaluation done and B12 test done immediately.
Brief Answer:
Yes, if EMG NCV study is positive then she may have facial nerve disease.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Yes, if EMG NCV study is positive then she is having facial nerve disease.
I need more information to conclude weather this is nerve related or stress related.
Please let me know
1. She is having these spasms since two years. Is she have stressful life since 2 years only or she also had stress before 2 years?
2. Does she smoke? In the past?
3. Diabetes and hypertension has been ruled out?
4. Does she have more symptoms in cold weather or winters?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Yes, if EMG NCV study is positive then she may have facial nerve disease.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Yes, if EMG NCV study is positive then she is having facial nerve disease.
I need more information to conclude weather this is nerve related or stress related.
Please let me know
1. She is having these spasms since two years. Is she have stressful life since 2 years only or she also had stress before 2 years?
2. Does she smoke? In the past?
3. Diabetes and hypertension has been ruled out?
4. Does she have more symptoms in cold weather or winters?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answers to your questions below:
1. She is having these spasms since two years. Is she have stressful life since 2 years only or she also had stress before 2 years?
Yes, she did have stressful life before. But stress has increased many fold since I got married and was pregnant etc etc.
2. Does she smoke? In the past? No does not smoke
3. Diabetes and hypertension has been ruled out? No Diabetes, hypertension since age 27. On medications
4. Does she have more symptoms in cold weather or winters?
Yes, mainly seen in colder weathers. also starts after some cold/ sneezing.
Also, what exactly is facial nerve disease?
1. She is having these spasms since two years. Is she have stressful life since 2 years only or she also had stress before 2 years?
Yes, she did have stressful life before. But stress has increased many fold since I got married and was pregnant etc etc.
2. Does she smoke? In the past? No does not smoke
3. Diabetes and hypertension has been ruled out? No Diabetes, hypertension since age 27. On medications
4. Does she have more symptoms in cold weather or winters?
Yes, mainly seen in colder weathers. also starts after some cold/ sneezing.
Also, what exactly is facial nerve disease?
Brief Answer:
Possibility of facial nerve hypersensitivity is more.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So, in my opinion she is having facial nerve hypersensitivity. It is common in diabetes and hypertension. It is aggravated by stress, anxiety, cold weather etc.
So best treatment is control of hypertension, diabetes, stress and anxiety.
Pregabalin with vitamin b 12 should be started.
And if she is ready, better to get done EMG NCV study.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.
Possibility of facial nerve hypersensitivity is more.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So, in my opinion she is having facial nerve hypersensitivity. It is common in diabetes and hypertension. It is aggravated by stress, anxiety, cold weather etc.
So best treatment is control of hypertension, diabetes, stress and anxiety.
Pregabalin with vitamin b 12 should be started.
And if she is ready, better to get done EMG NCV study.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the replies.
A few more questions:
1. What exactly is facial nerve hypersensitivity and what causes it?
2. Whom do we contact exactly first, a physician or neurologist? the last time we went to one he directly ordered a CT scan and we were scared. Our family physician later told us it is not required at the moment. Hence I hope you have understood how larger hospitals try to misguide patients in the money making business.
Thus I have posted the query here online like most others here to understand the problem better and know what our approach should be to the same.
A few more questions:
1. What exactly is facial nerve hypersensitivity and what causes it?
2. Whom do we contact exactly first, a physician or neurologist? the last time we went to one he directly ordered a CT scan and we were scared. Our family physician later told us it is not required at the moment. Hence I hope you have understood how larger hospitals try to misguide patients in the money making business.
Thus I have posted the query here online like most others here to understand the problem better and know what our approach should be to the same.
Brief Answer:
Better to consult neurologist.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Actually diabetes and hypertension cause micro vascular complications. It causes reduced blood supply to nerves. And this causes Improper function of nerves.
She might be having above mentioned pathology in facial nerve.
So better to consult neurologist and discuss all these.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your mother. Thanks.
Better to consult neurologist.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Actually diabetes and hypertension cause micro vascular complications. It causes reduced blood supply to nerves. And this causes Improper function of nerves.
She might be having above mentioned pathology in facial nerve.
So better to consult neurologist and discuss all these.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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