Definition
For us, the face represents the gateway to the social environment. The first glance usually goes to the face of our counterpart, which is why the majority of people attach particular importance to the health and care of the face. If there are “irregularities” in the face, this is often immediately visible to everyone.
This can be a burden for the person concerned. Twitching is also an unwanted conspicuousness that can disturb or irritate both the person affected and the person opposite. Muscle twitches are known in the technical language as myoclonies or fasciculations.
If facial twitches occur, they can have different causes. The spectrum ranges from emotional states, to the effect of various substances, to serious diseases. Even if a trivial origin of the muscle twitching is usually to be expected, certain diseases should be excluded by a specialist if they are recognizable as regular.
Causes
Before worrying about serious diseases, it should be clear beforehand: Twitching in the face can be triggered by small things. For some people, stress at work is enough and “the eye gets nervous” by twitching the eyelid. All in all, emotionally charged states favour the occurrence of such phenomena.
Too little sleep or a slight magnesium or potassium deficiency can also trigger such symptoms – but these usually recede again. While muscle twitching can occur naturally under tension or during sleep, there are also some neurological diseases whose clinical picture is characterized by involuntary twitches. In rare cases, only the face is affected, but if there are repeated (long-lasting, disturbing) facial twitches, epilepsy, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and encephalitis should be ruled out.
Furthermore, a spasm hemifacialis can be the cause. This is an irritation of the facial nerve, which is responsible for the mimic muscles (facial nerve). However, this is a rather rare clinical picture.
Muscle twitching is far more frequently associated with a so-called tic disorder, which is a disease from the fields of neurology and psychiatry. Patients repeatedly and compulsively repeat a certain movement or utterance, usually triggered by certain triggers. Tourette’s syndrome is particularly well known in this context.
Taking medication and other substances can also cause facial twitches. Antipsychotics (or neuroleptics) are mainly used in schizophrenia, mania and psychotic delusional or excited states. Especially the typical neuroleptics (e.g. Haloperidol®, Chlorpromazin®, Melperon®) cause extrapyramidal motor disorders, which can manifest themselves, among other things, in facial muscle twitches.
Excessive alcohol consumption and illegal drugs may also cause facial twitches under certain circumstances. In principle, various drugs can cause muscle twitches or cramps. Especially the activating substances such as amphetamines (Speed), MDMA (Ecstasy), cocaine or methamphetamine (Crystal Meth) lead to an increased need for movement.
This activation can exceed the controlled movements and then trigger involuntary twitches in the face and other muscles of the body. Another possibility is that the twitching occurs after use. This is due to the activation of the body on the one hand and an electrolyte system that has been brought out of balance on the other.
Due to the increased movement, consumers sweat, which causes them to lose electrolytes, and the muscles are overstrained. These react either with cramps or with a short-lived overexcitability. Excessive use of cocaine and heroin also causes severe nerve and muscle cell damage.
In general, any misuse of medication and drugs can lead to serious damage and death. Please seek medical help if this applies to you. Besides illegal drugs, alcohol can also cause facial twitches.
Although it is valued in our society as a stimulant, it should not be underestimated that alcohol is also addictive and can seriously damage the body and psyche. On the one hand there is the acute alcohol intoxication – the poisoning with alcohol after excessive consumption.In addition to nausea, vomiting and disturbances of consciousness, muscle twitching can also occur. These are caused by spontaneous activation, which is due to alcohol poisoning.
The twitching usually stops as soon as the acute condition is overcome. On the other hand, there is the systematic abuse of alcohol over many years. Alcohol is a nerve poison, which in the long term attacks and destroys the nerve cells in the body.
This leads to a so-called denervation. This results in a spontaneous activation of the muscle cells, because the limiting factor of the nerves no longer exists. The twitching can then also be permanent because the tissue has been irrevocably damaged.
Multiple sclerosis is a disease in which the insulating sheathing of the nerve cords is damaged by the body’s own immune system. This leads to hyperexcitability or failure of these nerves. The disease usually progresses in relapses, with some of the symptoms usually receding over a period of time.
Many patients report facial twitching during an episode. These can often be seen as the first sign of impending deterioration, as small nerve fibers are responsible for the movements (and can be triggered more quickly when excited). The eyelid seems to be particularly often affected.
In addition or isolated, the corner of the mouth may also twitch. In principle, these movements are possible in all facial muscles, but they are particularly noticeable in the affected person’s eye or mouth, as they can disturb or impair interpersonal communication. In fact, it is possible that facial twitches are the result of epilepsy.
In particular, if the twitching occurs repeatedly and is accompanied by twitches in other parts of the body, epilepsy is all the more likely. As a rule, such types of epilepsy are not dangerous, but a neurologist should still be consulted in the event of such symptoms. Although it is not always possible to make a clear diagnosis of epilepsy, the specialist can usually assess whether epilepsy is present or whether other causes are more likely on the basis of the symptoms and with the help of apparatus examinations (especially EEG).
If necessary, he can also initiate anti-epileptic therapy, which can usually reduce or even completely eliminate the twitching relatively quickly and effectively. Stress can have various consequences on the body. Different systems go crazy when stress situations persist.
If everyday life is emotionally stressful, this has an influence on sleep, hormones, mood and numerous other aspects. Twitching in the face can be an expression of such emotional imbalance. As a rule, a pathological cause cannot be found.
Often young people in particular present themselves to neurologists because of such symptoms, having read or heard about serious illnesses that may be associated with muscle twitches. However, even after a short diagnosis it turns out that it is not a disease but the existing stress situation that is to blame for the involuntary movements. Stress can be triggered by anything that stirs up the patient emotionally: a separation, an argument, work, the pressure to perform or the loss of a loved one.
The therapy consists of coping with the personal problems, possibly in combination with talk therapy, and learning stress management techniques (e.g. meditation, yoga or similar). This might also be of interest to you: How can I reduce stress? Nervousness is a reaction of the nervous system.
It reacts to a stressful situation, which is connected in the memory with negative experiences. Nervousness can occur in a normal context, e.g. during a second attempt after a failed test. Nearly every person knows the feeling of nervousness and can remember corresponding situations.
Some people with a psychiatric or mental illness are confronted with such situations every day. The main focus here is on an anxious personality disorder and social phobia. In both disorders, contact with other people and especially with strangers is a major problem.
The fear of doing something wrong, of saying something wrong or of otherwise attracting negative attention is extremely high. The fear and insecurity express themselves, for example, in facial twitches.These in turn are perceived as unpleasant and therefore lead to further avoidance behavior – a vicious circle for those affected. Often a psychological or psychiatric treatment (e.g. talk therapy) can help to deal productively with the fears and bring about an improvement.
Facial twitching can also be caused by the psyche of the affected person alone. Every person reacts differently to excitement, stress, joy and suffering. While some people live out their feelings on an emotional level, for others the mind hits the body again.
It is precisely such extreme emotional states that can lead to facial twitches, which are then an expression of the emotional state of stress. The smallest muscle twitches or fasciculations of the eyelid are particularly frequent. These can last for varying lengths of time, but usually disappear after conscious emotional relaxation. The fear of what the twitching means can in turn intensify the symptom.
