HomeAnswersPsychiatryphysiological twitchesHow to control the involuntary movement of lips?

My left half of the upper lip move abnormally whenever I talk. Why?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At August 28, 2020
Reviewed AtFebruary 3, 2023

Patient's Query

Hello doctor,

Whenever I talked to someone face to face, my left half of the upper lip moved more than the rest of the lips. I got conscious of it. It happens more when I get conscious. I feel it is in my mind and I can totally control it but I lose patience. Some days it is better, and some days it is not. When I just wake up in the morning, it does not happen because it is not in my mind initially. But gradually, as soon as I become totally conscious, it starts happening when I talk to someone. And this has made me lose confidence.

Hello,

Welcome to icliniq.com.

I can understand the concern behind your query. It looks like there may have been some twitching/tremors of your upper lips due to some stress, anxiety or tiredness. It appears that gradually you have been overthinking about it leading to a vicious cycle of more stress which has undermined your self-confidence. It is positive that it does not happen when you wake up and you realise that it is more when you are self-conscious about it.

Is it just your left upper lip that moves more or does it involve any other muscles on your face? Is it like a tic or hemifacial spasm? Does this problem with your lip happen when you are talking to your close family or friends? Have they noticed it or is it just your perception? It may help to discuss with a trusted family member or friend to get an objective idea. Do you have any other health problems? Has there been anything else stressful in your life that could have contributed to your symptom?

Initially, I will recommend relaxation strategies that will help you to stay calm and avoid over focussing on this symptom.

1) Try slow and deep breathing exercises. Inhale through your nose for four counts, pause for two counts and then exhale through your mouth for eight counts of breath. Make the breath so deep that it reaches and expands the belly. Do it for 5-10 minutes or longer. You will notice that you are able to calm down.

2) Try Jacobson's progressive muscle relaxation exercises for 15 minutes daily. There are helpful guidance videos online which you can follow.

3) Try to maintain a diary for two weeks. Try to document when these symptoms occur, your thoughts and feelings at that time. It may help to identify if there are any unhelpful thought patterns that is making you less confident.

4) Try to eat a healthy balanced diet with adequate fruits and nuts rich in antioxidants and nutrients.

If symptoms are persistent or progressive, a comprehensive assessment will be needed.

I hope this helps.

Patient's Query

Thank you doctor,

It is a kind of hemifacial spasm but it mainly involves my upper lips of the left side.

And yes, my close friends and family members have noticed too. Actually, in the beginning when it was mild and nobody noticed it, I could control it whenever I wanted to. When one of my close friends noticed it and told me about it, that is when I got conscious about it.

Also, when I am with someone or doing something which totally engages me, it does not happen. For an example, I like singing so when I sing, it does not happen much. And there are certain alphabets or words at which it happens more.

I am pursuing a medical degree too. So during my exams, I used to read it out loud and understand but when this started happening, I could not read it out loud because my focus used to go on my lips and it used to make me so sad that I got anxious about it. And so to reduce it, I had to keep my finger on the left side of the lip and readout.

I feel it is totally upto me to get rid of it because I feel it is psychological but I need to find out how. I mean I do not want it to run into my mind when I am talking to someone face to face. Also, I have started doing meditation recently. I have become calmer. But still, whenever I talk to someone, it happens. Please help.

Hello,

Welcome back to icliniq.com.

It is good to have this additional information. Many conditions like tics and spasms tend to get better when you are relaxed and productively occupied. It can be more prominent when you are stressed, anxious, and tired. So it can wax and wane.

Meditation is a good idea. Also, try to follow the relaxation strategies I suggested earlier. It will lead to gradual improvement. Try not to overthink about it as it can be counter-productive. If there are any additional worries and excessive anxiety, you can have psychological therapy like CBT (cognitive behavior therapy).

Also, since this unusual lip movement spasm has been there for a while, I will suggest consulting a neurologist as well to ensure there is no underlying neuromuscular cause. It is better to have a face to face consultation with a neurologist in your city and obtain their opinion.

I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Suresh Kumar G D
Dr. Suresh Kumar G D

Pediatrics

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