Besides the forehead twitching superstitions or myths, there are various reasons why you can end up with this problem on your left, side or the entire forehead. It can be accompanied by several other symptoms depending on the cause. Let us explore the medical causes of this condition
Is your twitching forehead? Is the twitching causing you discomfort or even embarrassments? Are you worried that the twitching may be a result of a serious underlying health condition?
Forehead twitching also known as forehead spasms is the involuntary muscle constrictions or contraction in the forehead. While the spasms may not be painful, they do cause personal and social discomfort, embarrassment as well as impaired vision due to spontaneous eye closure.
However, some people may experience twitches on side of the face which is referred to as hemifacial spasm(HFS)/tic convulsif. The spasms can last from 1 second to several minutes and are usually spontaneous.
The onset of HFS usually involves the contraction of the muscles around the eye, with time the spasms may exacerbate and advance down one side of the face to include the mouth and cheeks. in severe cases, the twitching extends to the forehead and neck.
In circumstances where an individual is under anxiety, stress or fatigue forehead twitching tends to worsen. Additionally, other external stimuli such as touch, chewing and sunlight can exacerbate the twitching.
Causes of forehead twitching or spasm
All facial movements are controlled by the seventh cranial nerves referred to as the facial nerve. The facial nerve begins in the brain stem and further branches out to all parts of the face which include the neck, forehead, mouth, eyes, and cheeks.
Facial twitching is a result of hyperactivity in the nerve system-which is caused by blood vessel pulsating or compressing the root of the facial nerve as it extends from the brain stem. These unusual signals cause the facial nerve nucleus to be hyperactive thus propagates signals to the face which results in abnormal twitching.
However, in some cases, the hemifacial spasms can result from a tumor, injury to the facial nerve or Bell’s palsy.
Symptoms of forehead spasms
HFS is a very rare condition which affects about 0.008% of the population in the United States. Normally, the condition is more common in women as compared to men. additionally, the onset of HFS is common during middle age with few cases of HFS development before 30years.
According to Mayfield clinic, approximately 92% of the HFS cases, the twitching starts from the eyes and advances down the face with time, while the rest of the cases report HFS starting from the chin and advancing upwards.
The diagnosis of spasms usually involves a careful analysis of the patient’s medical history as well as carry out a neurological exam.
In some cases, an MRI scan may be recommended to eliminate the possibility of any underlying conditions like a brain aneurysm, brain tumor or AVM which may be the cause of facial nerve contraction or compression.
The next process involves a facial electromyogram together with a nerve conduction velocity to study your face, measure muscles, and nerve electrical activity respectively.
Treatment for HFS may vary depending on the patient’s treatment choice. Nonetheless, its vital for the patient to chose the treatment method based on a thorough understanding of the disease, the possible upside, and downside of each treatment option.
Normally, hemifacial spasms usually start with mild involuntary twitching around the eyes which can easily be treated or controlled by:
- anti-convulsant medications such as carbamazepine or phenytoin for blocking the nerve from firing.
- Muscle relaxants clonazepam or diazepam
These medications are successful in treating the mild cases of HSF. However, they are associated with side effects such as nausea, drowsiness, skin rash, unsteadiness and dependence.
Normally, once they’ve been administered the patient has monitored on a routine basis and blood tests carried out to ensure that the drug levels in the bloodstream remain safe and don’t promote the development of blood disorders.
However, medical therapy alone is normally not effective for long-term twitching control hence the need for other treatment.
2. Botox injections
The procedure involves the use of a fine needle for 1-3 injections into the facial nerves. The injection contains a protein which is produced by Botulinum bacteria which leads to paralysis of muscles due to blockage of the electrical signal that causes the muscle movements.
Botox works within 3 days and the results last for up to three months. The procedure can be repeated as often as possible however, the effectiveness subsides after some years due to the accumulation of antibodies.
Moreover, Botox is associated with side effects such as drooping eyelids, sensitivity, eye irritation and temporary facial weakness.
In some cases, medical therapy, as well as Botox injections, fail to control the muscle spasm or even cause adverse side effects.
In such cases, a surgical procedure referred to as microvascular decompression may be used to relieve the nerve contraction.
The procedure involves craniotomy (making a hole in the bone) behind your head to reveal the facial nerve at the brain stem, putting a Teflon sponge between the compressing blood vessel and the facial nerve.
Like other surgical procedures, there are risks involved, the most common include reduced hearing and facial weakness but approximately 90% of the patients resume their natural lifestyle after 2 months of the procedure. Nonetheless, to reduce the complications, the surgeon uses intra-operative monitoring of the facial and hearing nerve cells during the procedure.
Forehead twitching myths and superstition
Beside the above medical causes, there are many societies that associate a forehead twitching with something.
For instance, according to to.dreamozone.com, “twitching of right side of the forehead indicates a gain in real estate, properties profit etc. It means you will rise through your intellectual ideas” while twitching of left side of forehead superstition indicates gain, profits, and success but the efforts will bear fruit a little late”.