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facial twitching
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facial twitching

I am a 32 year old female and have had a facial twitch that has been going on for 5 months and is mostly on the right eyebrow and eye area of my face but does affect the left side occasionally it is fairly consistent through out the day coming and going regularly.  It has gotten more pronounced in the last month also.  My doctor told me lack of sleep and caffeine could be triggers but I have had no caffeine and regular sleep for the last 2 months and it has not gotten any better.  Any ideas on what the cause could be?
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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 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.

If your symptoms are restricted to the eye region, you may have blepharospasm, or involuntary contractions of the eyelids, a form of dystonia. This is typically not a serious disorder but can be annoying, particularly when the eye twitching is frequent or foreceful. If so, treatment can be botox injections in to the eyelids.

If your symptoms are not restricted to the eye region but also involve the cheek and the mouth, your symptoms may be consistent with a disorder known as hemifacial spasm, which is basically involuntary muscle contractions that start around the eye but later involve the cheek and mouth area. This most typically affects only one side of the face but in rare cases can involve both sides of the face. The cause is not always identifiable, though in some cases compression of the facial nerve (the nerve that innervates most muscles of the face) is found, due to a small blood vessel looping around the nerve or a small tumor pressing on it. An MRI of the brain is typically recommended in patients with hemifacial spasm to exclude an identifiable cause. If the spasms are particularly uncomfortable, injection of botox into the affected muscles is beneficial to most patients.

Depending on the exact history and examination, another consideration would be a focal seizure affecting the face, and in this case may be termed epilepsia partialis continua. Please understand I am not trying to imply I think you have seizures, but only providing the general possibilities.

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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