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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31329
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Hi. I have been having a twinge on the right side of my face

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Hi. I have been having a twinge on the right side of my face just a little to the right of my mouth ( about 1 1/2” inches away) for a day and a half. Is this a precursor to a stroke or just nerves ?

I am diabetic and had a very minor stroke 2 years ago. The twinge is not painful but is pretty consistent in twinging during this time period.

Thank you

Greetings Chuck.

Is this muscle twitching / muscle fasciculation?
Do you have any numbness or abnormal sensation or weakness of face?

Any other symptoms like headache, nausea, dizziness, weakness of limbs, imbalance?

Dr. Arun

Customer: replied 3 years ago.

I have quite a few health issues going on, neuropathy, vertigo and imbalance, chronic fatigue and pain. Due to one kidney I cannot take

anything to relieve the FM pain or for all the severe osteoarthritis I have. I have anxiety and take lexapro, Maybe I am just having some anxiety. BP is normal and pulse good. We have some stressful things going on at this time. Just wanted to run it by a doctor. I see mine next week but I have never had this twinge on my face.

Hello Chuck,

As you mentioned, this can be just anxiety. Neuropathy occasionally also can be responsible for it. Usually it is benign and resolve on its own, but persistent of symptoms may need following investigations;


1) electromyography (EMG)

2) nerve conduction velocity (NCV)

3) blood electrolytes like calcium, magnesium, potassium, sodium, etc

4) thyroid and parathyroid function tests

5) blood chemistry and complete metabolic profile


The common causes can be;


1) Idiopathic; no cause is ascertained and majority falls in this group. Anxiety predisposes for it.


2) Increased caffeine intake


3) Increased alcohol intake (this may not be true for you)


4) Medications


5) Deficiency in diet and nutrients / minerals


6) Some neurological diseases; uncommon.


With normal pulse and BP, I would not be worried. For fibromyalgia, you may try following;


1) Aerobic exercise; low-impact aerobics, walking, water aerobics, stationary bicycle.

2) Heat, massage, and other treatments like sauna, hot baths and showers, hot mud, and massage.

3) Trigger-point injections,

4) Acupuncture,

5) Chiropractic manipulation,

6) Myofascial release

7) Neural pulse stimulation (CNP) device

8) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT)

9) Relaxation training and biofeedback.


For osteoarthritis, supervised physical therapy and deep electrotherapy are the most efficacious treatment. You may consider consulting an MD in physical medicine and rehabilitation.


Please feel free for your follow up questions.


I would be happy to assist you further, if you need any more information.


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