what is causing my cheeks to twitch when im nervous and try to smile?
Person's Gender: Male
Person's Age: 21
different skin cleansers
are you there?
do you know anything about my problem?
so how long have you had this problem?
it started about 6 years ago but only once
is it only when you are nervous?
are you still typing, you wrote only once......
no i thought u were it said u were typing
the chat is all messed up
anyway, your condition is caused by something called ephaptic transmission
what is that?
when you are nervous, your nerves behave differently, your facial muscles are just loaded with nerves,
so the ratio of nerve end plates (neuromuscular synapses) to nerve cells is very high.
how can i treat it?
for example in your biceps, one nerve endplate serves about 2 to 5 thousand muscle cells. the nerve fires and all the muscle cells in that "motor unit" contract
in your face, especially the small muscles of the face, that nerve ending controls like 50 muscle cells only. so when it fires only 50 cells contract.
ephaptic transmission comes when the axons in your nerve cross fire, kind of like a short, the insulation is too thin, and it jumps from one motor unit to another. that give you a twitch.
we call it a fasciculation
but it is the same thing.
unfortunately there are only a few things you can do
as you probably have figured out.
you need to stay calm. anxiety meds will control your facial nerve discharges
you can take potassium and magnesium salt solutions to quiet your neuromuscular junction (synapses)
is that all?
you can take medicines like quinine sulfate, or even better, if you like it, you can try to drink tonic water,(real quinine water)
they make specialty quinine waters now
and that will settle down your neuromuscular junction
you can do facial exercises, or stretching exercises or your face and that should decrease your ephaptic transmission
you can do botox
did you talk to someone about botox?
the problem is there are too many facial muscles
yes, they said it would be a bad idea around my smile muscles
so you end up treating only a few muscles and you still twitch
yes, your face is really just too complicated.
there is a condition called hemifacial spasm
that comes from facial nerve injury
but you don't have that I bet
you will out grow it < I bet
is there a surgery to remove nerves or is that just crazy?
well i guess thats about it, u helped me more then anyone else in the past 6 years thank you very much
I don't have anything a lot better. you could try some epilepsy meds but I think that is overkill
im not sure what those are but i would try anything
you are welcome do me a favor and try the custom made tonic water I hear that this works but havent really tried it with patients
so hang for one sec ok?
i defiently will thank you so much
they say that Schwepps tonic water has real quinine in it. you need real quinine. there is a medicine called quinine sulfate
but you are too young and it can give you strange heart rhythyms so forget that
try schwepps and let me know ok?
and try to stay calm
ya im researching it now it says its for malaria and leg cramps
but ill try it
right leg cramps are kind or a poor man's version of your problem
so how many cans a day do u suggest?
take care. please rate my answer if you feel I helped you ok The VA did a study and they looked at tonic water for leg cramps in old vets. they said 8 oz every night to prevent nocturnal leg cramps. for you I would say one glass twice a day???
ok, i will defiently rate you, thanks so much
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General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
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I have a few more questions about my problem.
You said the problem is with my nerves and that the coating is too thin. Is this the myelin sheath you were talking about? If so I read there are ways to thicken it by taking fatty acids such and omega 3 and fish oils as well as b12 vitamins. Is this true? and have you treated anyone else with this problem?
Thanks in advance.
Yes, exactly the myelin sheath is either thin or spotty in a few areas so the axons are together and short. I would say that you need your schwann cells that are making myelin to work harder, Facial massage has been shown to decrease this problem, thought to do so my increasing blood flow and nutrients to those schwann cells, Electical stimulation of the nerve at the parotid gland aslo of some benefit, but I would encourage you to get some warmed massage oil and massage your face at night. B vitamins certainly can help, I dont know about omega 3 and fish oils for this condition, I don't think they could hurt. What I have done with my patients is just what I stated in this paragraph.
Have your patients cured themselves completely by just massaging their faces at night? and would i have to do this for the rest of my life? and what do you mean by electrical stimulation? Thanks.
Electrical stimulation is done at the physical therapists office. It is like a TENS device, you put the electrodes on the facial muscles and you turn it up until they twitch slightly, and let it run for some time, it stimulates the nerve to regenerate. If you look at Bell's palsy patients as a group, 95% have complete remission, and 5% have residual deficits, like the twitching you describe or lid lag on the side, if I ask you to blink fast (have someone watch you blink fast in front of them, does your one eyelid lag behind?) You can continue to build myelin for a year or more.
I will try the eyelid thing. So you have had other patients with this problem and they got cured?
I have not had a patient only with facial twitching and no history of bell's palsy. That is unusual.