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I have left sided hemifacial spasicity. My left lateral

Customer Question
I have left sided...

I have left sided hemifacial spasicity. My left lateral orbicularis oculi muscle twitches for hours at a time and recently my left lip has started to twitch minimally every now and then. I have no other symptoms. This has been going on for several months. I am very annoyed by it. It’s embarassing because people can see it. I have read about irritation of the facial nerve by inflammation of blood vessels in the brain stem, tumors etc. I work for a dermatologist and I read that one of the treatments is Botox to the orbicularis muscle. Do you think I need an MRI or can I just have botox?

Doctor's Assistant: Do you keep personal medical records to help track this?

No

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

No. No medications or allergies. Only vitamins. Family history of Afib(Dad) , breast carcinoma in Situ (Mom) and a sister with RA and IBD. I did have a herniated disc (L4-5) and I have had breast implants and 2 c-sections

Submitted: 8 months ago.Category: Neurology
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Answered in 16 minutes by:
12/10/2017
Neurologist: Dr. David, Board Certified MD replied 8 months ago
Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 50,156
Experience: Experienced physician in Neurology
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Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

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Neurologist: Dr. David, Board Certified MD replied 8 months ago

you should get a skull base and facial MRI scan first before trying botox.

these could be benign fasciculations of nerves as well

do you have bad anxiety symptoms? bad anxiety can cause benign fasciculations of nerves

low potassium and low magnesium levels can cause muscles to have a hard time to relax.

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Customer reply replied 8 months ago
Ok...I do have anxiety. Stressful job. What could cause inflammation of a blood vessel that could irritate the nerve? What are the chances of it being something “bad”?
Neurologist: Dr. David, Board Certified MD replied 8 months ago

sorry about your stressful job

we don't know why some people get inflammation of blood vessels which can cause pain in the trigeminal nerve

I can't examine you or know how bad your symptoms are.

bad stress can cause twitching of of nerves on the face.

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Customer reply replied 8 months ago
Ok. Thank you for your help! I will go for scan. Should I make an appointment with neurologist or GP for that? Thank you again.
Neurologist: Dr. David, Board Certified MD replied 8 months ago

you can see your GP doctor first.

your GP doctor can order an MRI scan

or can refer you to see a neurologist who can order it for you

Let me know if you have other questions.
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