Differential Diagnosis for Facial Twitch
- Single most likely diagnosis
- Hemifacial spasm: This condition is characterized by irregular, involuntary muscle contractions on one side of the face. It often starts with twitching around the eye and can spread to other facial muscles. The cause is usually compression of the facial nerve by a blood vessel or tumor, but it can also be idiopathic.
- Other Likely diagnoses
- Blepharospasm: A condition where there is involuntary blinking or spasms of the eyelids. It can be a standalone condition or part of a more complex movement disorder.
- Facial tics: These can be part of a broader spectrum of tic disorders, such as Tourette syndrome, where facial twitching is one of many possible symptoms.
- Essential tremor: While primarily affecting the hands, essential tremor can also manifest as a tremor or twitch in the face.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Stroke or Transient Ischemic Attack (TIA): Facial weakness or twitching can be a sign of a stroke or TIA, especially if accompanied by other symptoms like speech difficulties, weakness, or numbness in the face or limbs.
- Multiple Sclerosis: This autoimmune disease can cause a wide range of neurological symptoms, including facial twitching or spasms, due to demyelination in the central nervous system.
- Lyme disease: Neurological manifestations of Lyme disease can include facial palsy or twitching, among other symptoms.
- Rare diagnoses
- Dystonia: A movement disorder that can cause sustained or intermittent muscle contractions leading to abnormal postures or movements, including facial twitching.
- Wilson's disease: A genetic disorder leading to copper accumulation in the body, which can cause neurological symptoms including tremors, involuntary movements, and potentially facial twitching.
- Moebius syndrome: A rare neurological disorder characterized by facial paralysis and impaired eye movements, which could be mistaken for facial twitching in some cases.