Two days ago when I was eating I noticed that if I ate hot food on the right side of my mouth it would make the right side of my face twitch from the jaw upwards and closing my eye uncontrollably. Last night it started doing it with cold food such as ice cream as well. I wake up this morning and I'm getting ready and I pop a zit on the right side of my face and it twitches. I can just rub my eye now and the entire right side of my face twitches.
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 history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
Twitching of one side of the face can have several potential causes which can be distinguished between based on the distribution of twitching, the history, and in some cases testing.
Seizures, termed focal motor seizures (due to a variety of causes) can sometimes occur just in the face. These would not typically be triggered by stimuli (such as hot or cold) but would need to be excluded based on again the history and examination.
Hemifacial spasm is an involuntary contraction of the face. This often begins around the eye and later involves the cheek and mouth. The twitching is intermittent, usually painless but uncomfortable in some, and can be triggered by certain stimuli. Forceful eye closure (blepharospasm) may occur. There are several causes of hemifacial spasms, and if this diagnosis is suspected, imaging of the brain with MRI is indicated. If a structural lesion is not found on MRI, one theory is that there is a small blood vessel that could be looping around the facial nerve (the nerve to the face) causing abnormal transmission of electric signals, leading to the involuntary facial twitching. Hemifacial spasm does not typically progress, but can be treated with injections of botox into the affected muscles when it causes significant discomfort or distress.
Another cause of facial twitching in a specific (so-called segmental) distribution is related to a condition that also causes twitching in the palate (the back of the mouth), palatal myoclonus. This can also have several causes, and imaging of the brain is indicated to further investigate.
Evaluation by a neurologist is recommended.
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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