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Lip Twitching
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Lip Twitching

Around 8 weeks ago I began having a twitch in the right side of my upper lip. After a week or so, it started occurring in the bottom lip as well, and into the third week it only occurred in the bottom lip. I have some tightness in the right side of my cheek and jaw as well. I've also experienced some fasciculations in other parts of my body, but nothing as consistent as what is occurring in my lip.

I've seen my GP and after performing a basic neurological exam he informed me that this was Benign Fasciculation Syndrome and that it was nothing to worry about. However I'm still concerned. I am lead to believe that most cases of BFS clear up or move on to other parts of the body after a few weeks, where mine has stayed consistently in my lip.

Should I be concerned about a Brain Stem tumour? I understand that Myokymia is very similar to fasciculations and facial myokymia is a symptom of such tumours.

I'm just not sure if I should relax and accept the Doctor's prognosis or if I should push the issue a little further to have this more thoroughly examined.

Thanks in advance for any responses I receive!
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Avatar_dr_m_tn
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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Benign fasciculation syndrome (BFS) is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.

When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve your symptoms.

It is important that you and your primary care physician rule out other causes of muscle twitching. I would suggest you have basic labs checked including TSH and calcium. Additionally, if you develop any symptoms such as weakness or loss of sensation, you should have imaging. Lastly, if you have any risk factors for seizures (such as head injury, previous seizure, family history of seizures, CNS infections, etc), you may benefit from an EEG.

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

3 Comments
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Avatar_m_tn
Thanks so much for replying. Can you comment on the link between Facial Myokymia and Brain Stem tumor?

"Facial Myokymia" seems to be described as a continuos, fine rippling movement on one side of the face. But I'm unsure if that's the only definition when associated with Brain Stem tumors. Perhaps my lip twitching qualifies in this instance?

I understand that it's difficult to comment on my case specifically without examination, but in general does Facial Myokymia as associated with Brain Tumor present itself as simple twitching in any part of the face, or is it specifically this vermicular, continuos rippling that I've seen described?

Thanks again!

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