Diagnosis
Facial twitching is a gaze diagnosis, i.e. the doctor can see at first glance which symptom is leading the patient to him. The extent of the muscle twitching gives an indication as to whether it is really just fasciculation of individual muscle fibre bundles or whether it is a movement disorder. The latter can be caused, for example, by the long-term use of antipsychotics/neuroleptics.
Whether it is a harmless muscle twitch or whether it occurs in the context of an existing nerve damage can be proven by an EMG. In EMG, which means electromyography, small needle electrodes are inserted into the muscle to be examined in order to derive its electrical voltage differences. These can then be used to infer the activity of the muscle.If the EMG shows abnormalities, it is reasonable to assume that nerve damage is present.
Twitching in the mouth area
Twitching in the mouth most likely affects the tongue or the corners of the mouth and occurs psychologically (triggered by the psyche), through substance abuse or medication. The tongue is a dense construct of muscles and therefore reacts sensitively to even the smallest neuronal damage. While the smallest muscle twitches in other parts of the body cannot be seen with the naked eye, but can only be visualized in the EMG, they can be seen with the tongue.
Even stronger twitches are an indication of nerve damage. It is possible that damage to the responsible cranial nerve (hypoglossal nerve) is responsible for the symptoms. This nerve controls the entire tongue musculature, so that in case of nerve damage, twitching or even paralysis can occur. An incipient ALS (Amyotrophic Lateral Sclerosis) can also make itself felt at first by twitching of the tongue. Since this is a very serious nervous disease, a doctor should always be consulted if there is any suspicion.
How long do the twitches last?
A twitch in itself lasts only a fraction of a second. As soon as the “twitch” lasts longer, it is a cramp, which has other causes. Fasciculations often occur in rapid repetition one after the other.
The series can last only a few minutes, but also for hours. The longer the facial twitching lasts, the more stressful the condition becomes for the person affected. Fasciculations often occur again and again, even if they are not caused by a neuronal disease. However, if the duration exceeds the individual tolerance, one should not shy away from a visit to the doctor and seek professional help. Perhaps the specialist can recognize and uncover emotional problems that were previously hidden or not associated with the symptom.
