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Constant lip twitch
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Constant lip twitch

I am a 39 y/o male with mild tmj and sleep apnea, In July I had deviated septum surgery and two weeks into recovery i developed Bronchoitis. Dr Prescribed z Pack first  then switched over two levaquin. About 7 days into the medicine I developed a twitch/ spasm in my upper lip right in the center. I have been off the medicine for three weeks and it is still there. I have been to My family phy who did blood work normal except cholestrol 250. went back to the ent who  did septum surgery was not concerned stated wait another week if dosen't go away seea nureo. Went to the Nureo who did a exam stated dosen't see any problems with facial nerve or anything else for that matter. I had a sinus scan before surgery and a brain mri abot two years ago all normal. could the surgery have caused nerve damage or is this the sign of a brain tumor i get headaches but nothing that i have not had before sleep apnea related i believe.  
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a full history, it is difficult for me to tell you what the cause of your lip twitch is. However, I will describe to you causes in general of facial twitching.

Postoperative facial twitching is rare. It sounds like your surgery was only to your nasal septum; it is difficult to conceive that the facial nerve (which innervates the lip) was damaged in this surgery, because it is not located around the nerve. However, it is possible that certain nerve fibers to the upper lip were irritated from the surgery. The possibilities I can think of include myoclonus, sudden which are sudden lip jerks, or myokymia, a more rhythmical sort of wave-like movement. Other possibilities include dystonia, a contraction which can be intermittent or sustained. Medication-induced muscle twitches also occur. Hemifacial spasm is another possibility but it would involve your cheek and possibly your eye as well.

As you can see, there are several possibilities, and your lip abnormality may need to be further evaluated before a diagnosis can be made. It sounds like you have already had an MRI and have seen a neurologist; it may benefit you to see a movement disorders specialist if your problem does not resolve. If it persists, a test of the integrity of the facial nerve called an EMG/NCS which tests how electricity is conducted along the nerve and how muscle responds to it may be helpful; this test is difficult to conduct in the face but is still possible. My advice is that if your symptom persists, re-evaluation by a neurologist and possibly a movement disorder specialist may be helpful to you.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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