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Q. I experience muscle spasm above lips with no disturbance of other activities. Please help.

Answered by
Dr. Rajyaguru
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 18, 2020

Hello doctor,

I have been experiencing a muscle spasm above my lip on the left side. It is a rapid vibration that I can see when I look in the mirror and feel when I touch the affected area. I do not experience any pain when the spasms are happening and I can still talk, smile, and otherwise move my face.

I first began noticing the issue last year. The spasms seem to come and go. For the past few days, they have been occurring at night. Sometimes the spasm is still happening when I go to sleep, but by the time I wake up, the spasms have stopped. Last night, I noticed the spasm started after a workout where my heart rate got up to 171 bpm.

I have talked to a few doctors who have recommended magnesium and I have noticed that when I take 400 mg per day dose, the issue does not last as long. That said, the spasms are still happening. I do not drink large amounts of caffeine never more than one cup a day so I do not think it is related to that.

A couple of weeks ago, I noticed a similar spasm under my left eye, but that only happened for a day and then disappeared completely. Last winter, I noticed an eye spasm as well, which lasted for a few weeks, but then disappeared entirely. My GP did HbA1c, TSH, T4 free, CK, sedimentation rate, magnesium, basic metabolic panel, and GFR all results came back normal.

She provided me a referral for a neurologist and I am working on getting an appointment. There are some long wait times so I am hoping to speak with a specialist in the meantime to get a little bit better of an understanding of what this might be.

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Hi,

Welcome to icliniq.com.

I can understand the issue. It is basically the facial muscle spasm that you have. In the classical pattern, it involves larger areas of the face and not smaller area or single muscle. The cause for it can be mild compression (more of irritation than compression) over the nerve which runs into the facial muscles.

The site of compression can be near its origin secondary to pressure from a neighboring blood vessel. The less common cause can be viral involvement of the nerve in the ear. For that, you should be investigated with the TORCH panel (viral screening test). Depending on results we can plan further management.

A short therapeutic course of steroids may help. If it persists for a long time then Botox injection into the muscle to inactivate it will help.


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