What are the causes of facial muscle twitching?

Facial muscle twitching is largely caused by facial spasm. The common causes of this adverse symptom are excessive fatigue and excessive tension. It is also related to diseases such as arteriosclerosis and hypertension. Facial muscle twitching is a disease that mostly occurs in middle-aged and elderly people, and mostly in women, but it can also occur in children. According to clinical data, the youngest patient is only 2 years old.

1. Causes of Facial Twitching

Hemifacial spasm is an involuntary twitching of the hemifacial muscles that occurs paroxysmically. Usually, it is limited to one side of the face, so it is also called hemifacial spasm. It can occasionally occur on both sides. It usually starts from the orbicularis oculi muscle and gradually spreads to the cheek and even the entire half of the face. Reverse development is rare. It may be aggravated by fatigue or tension, especially when talking or smiling. In severe cases, it may present as a convulsive state. The onset usually occurs in middle age, with the youngest age reported being two years old. It was previously believed that the disease was more common in women, but statistics in recent years have shown that the disease has nothing to do with gender. At the end of HFS development, mild facial paralysis may occur in a few cases.

2. Clinical manifestations of hemifacial twitching

Hemifacial spasm is a twitching on one side of the face (some people experience bilateral spasm). The more nervous and excited the person is, the more severe the spasm will be. Since the initial symptom of hemifacial spasm is eyelid twitching, and there is a saying among the people that "left eye twitching means wealth, right eye twitching means disaster", people generally do not take it seriously. After a period of time, the lesion forms and develops into hemifacial spasm, which affects the corners of the mouth and, in severe cases, the neck. Hemifacial spasm can be divided into two types: one is primary hemifacial spasm, and the other is hemifacial spasm caused by the sequelae of facial paralysis. The two types can be distinguished based on their symptoms. Primary facial spasm can also occur in a static state, and the spasm will be relieved after a few minutes and is uncontrollable; the facial spasm caused by sequelae of facial paralysis only occurs during actions such as blinking and raising eyebrows.

3. Prevention of hemifacial spasm

Idiopathic hemifacial spasm is more common in adults over 40 years old and may be related to arteriosclerosis and hypertension. If the patient is a young person under 30 years old, it often suggests that there are nerve irritation lesions in the cerebellocerebellar angle, internal auditory canal, geniculate ganglion, middle ear mastoid or parotid gland, such as congenital cholesteatoma, hemangioma, acoustic neuroma and arachnoid cyst. Spasm is a dangerous signal of the disease. In such a situation, a comprehensive neurological examination should be carried out in time. If necessary, a cranial CT or MRI examination should be performed. It is generally advisable to observe and wait to avoid delaying treatment.

In order to prevent complications of microvascular decompression surgery, first of all, attention should be paid to the surgical position, avoiding sitting or semi-sitting positions to prevent a large amount of air from entering the veins and causing multi-organ air embolism. The surgeon should strengthen basic surgical skills training, close the opened mastoid air cells in time, be proficient in using the suction device and its pressure adjustment, carefully identify the vascular compression form of the facial nerve exiting the brainstem area, avoid blind electrocoagulation, separation and cutting of blood vessels. If you pay attention to the above points, the occurrence of complications will be significantly reduced.