bizarre combination of sx's...

A few years ago I had a few incidents of a facial "spasm" It wasn't really a spasm but looked like someone had threaded a needle, knotted the thread and stuck it through my cheek knot from the outside and was tugging on it accompanied by tingling feeling in the left cheek and jaw area. I went to a neurologist who did an MRI and found nothing. It went away and I just wrote it off.

About 6 months ago, I started with a really annoying horizontal (upper only) eyelid twitch on the left side. I can see it but doubt anyone else can unless I point it out. I also have an occasional outside lower lip spasm/twitch accompanied by tingling in the lower facial area on that side. Also slight, no one would notice if I didn't point it out. Doesn't affect the upper lip at all. This is also occasional, happens for maybe 30 seconds numerous times a day. It may cease for a few days, even a week then starts back up. There is no drooping of either the eyelid or the lip.

About a month ago, I had a few random muscle twitches, one in my arm, one in my leg on the same body side if I recall correctly. No accompanying weakness or anything.

I've also developed an approximately 3 x 5" indentation on my upper outside thigh muscle on the opposite side, if that's related or not, I've no clue.

I do have a history of cholesteatoma in the left ear. I also see a chiro when I need to for cervical issues.

I work out on a home gym at least 2x a week and have lost about 10 lbs. in the last few months due to really cutting out almost all junk food and rarely eat red meat (familial hx of heart disease). Don't know if this has anything to do with the thigh issue. My weight is 123-125 currently and I'm 5'5". I take no medication other than occasional pseudophedrine for sinus issues/allergies and a deviated septum. No chronic health issues.

Not even sure who to see about this as I don't know if it's neurological or not...

TIA for any insight or input.

[Neuro Forum]

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.

Regarding the twitching that occurred in your cheek and your eye, one possibility is a condition called hemifacial spasm. This is a disorder in which there is involuntary muscle twitching or muscle spasm on one side of the face. This often involves muscles around the mouth, cheek, and eye. It is episodic, and as you describe, appears as if there is a hook pulling the mouth and cheek up or the eye down. In a minority of patients, a lesion affecting the brainstem stem (the lower part of the brain), or something pressing on a nerve called the facial nerve is the cause. In most, the cause is not always identifiable and it is thought there is some sort of irritation to the facial nerve. If your twitching occurred only a few times and has resolved, this may have been a transient irritation, perhaps due to a viral illness or something else. However, if the twitching around your eye or in the face persist, then it would be a good idea to be evaluated by a neurologist. Imaging of the brain is usually indicated to make sure there is no identifiable or and/or treatble cause. Otherwise, hemifacial spasm does not always need to be treated but if it is bothersome to the patient, injections of botox into some of the muscles can stop the twitching temporarily. Avoidance of stress, fatigue, bright lights can sometimes reduce twitching triggers.

Random twitches in the arms or legs that resolve are usually of no clinical significance, and are usually due to what is called benign fasiculation syndrome which are just twitches that occur in response to anxiety, stress, exercise, caffiene, cold exposure, and others. However, if they persist and are widespread, evaluation by a neurologist is also recommended for these.

It is difficult for me to comment on the indentation in your thigh without more information, I recommend you show this to your PCP/family doctor at your next visit and he/she can determine what it may be and if whether or not further testing is indicated for it.

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

[lorraineg57]

Thanks for the response. I had an MRI of the brain stem done when the initial spasm happened years ago. I had wondered if this may be in some way related to the cholesteatoma in the left ear. As far as history, there really isn't any aside from what I've documented here. I'm very healthy, take no medications, no chronic disease or illness.

I may watch this and see if it progresses. The lip twitch is a newer sx within the last month. The off and on eyelid twitch has been going on much longer. I actually work for at PCP's office so I may request that they order testing if it doesn't resolve.

Thanks again.