What causes trembling lips? Beware of facial spasm

Lip trembling, or lip twitching, is often caused by hemifacial spasm. Hemifacial spasm is mostly caused by abnormalities in the facial nerves. This disease can cause mental tension and affect daily work and life, so you should go for a check-up in time.

1. Symptoms and Signs

Hemifacial twitching refers to the paroxysmal painless contraction of the muscles innervated by the facial nerve. The first symptom often begins with a slight twitch of the orbicularis oculi muscle of the lower eyelid, gradually spreading upward to all the orbicularis oculi muscles, and then to the lower facial muscles, especially the corners of the mouth. In severe cases, the entire facial muscles and the ipsilateral platysma muscles may spasm. Severe spasm of the orbicularis oculi muscle may make it impossible to open the eyes, thus affecting walking and work, and may be accompanied by mild weakness and muscle atrophy. It worsens when you are stressed, tired, or exercising on your own, and disappears during sleep. Facial muscle twitching is not accompanied by pain, and voluntary contraction of facial muscles is generally not affected when there is no facial muscle twitching.

Electromyography revealed that stimulation of the marginal mandibular branch induced the musculus orbicularis oculi.

oculi, MOO) myoelectric potential, which is called MD-OC response. Normal people do not have this reaction, but patients with hemifacial spasm all have the MD-OC reaction.

2. Pathological Causes

The cause of hemifacial twitching is not clear, it may be caused by ectopic excitation or pseudo-synaptic transmission of the facial nerve. In recent years, there have been reports both at home and abroad that surgical and autopsy materials have confirmed that facial muscle spasm is caused by some kind of compression that causes pathological interference in the conduction of the facial nerve. The vast majority of patients suffer from cross-compression of normal blood vessels, such as the posterior inferior cerebellar artery, anterior inferior cerebellar artery, and vertebral artery.

Occasionally, it is caused by compression of the facial nerve root by an aneurysm, arteriovenous malformation, or brain tumor. A very small number of patients experience muscle spasms on the affected side after trauma, tumors or surgery.

3. Disease Diagnosis

Need to be differentiated from the following diseases:

1. Functional blepharospasm occurs in elderly women, often bilaterally, without twitching of the lower facial muscles.

2. Habitual tics often occur in children and young people, often presenting as obvious muscle contractions and are related to mental factors.

3. Meige syndrome is also called blepharospasm-oromandibular dystonia syndrome, which is characterized by bilateral blepharospasm, accompanied by dystonia of the mouth, tongue, facial muscles, mandible, laryngeal and cervical muscles. It is more common in elderly women.

4. Neuropsychiatric inhibitors cause facial dyskinesia

Patients with dyscinesia have a history of recent use of strong tranquilizers such as perphenazine, trifluoperazine, haloperidol, or metoclopramide, which manifests as compulsive opening or closing of the mouth, involuntary tongue extension or retraction, etc.

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