Facial Twitches? Can anyone help?

[damien8]

Hello all,

I posted previously about my mother being diagnosed with AN.

They discovered it last November when she went in for a test after noticing a loss in her hearing.

Recently, she has been having facial twitching episodes. I saw one the other day when her face sort of just froze up for a few seconds, looking as though he eye was closing slightly. Other times she has a twitching in the eye.

The facial twitching started a couple of months ago, and has been occurring at a more frequent rate as time passes.

My mother found something online about Facial Nerve Schwannoma, and mentioned it to her doctor the other day. He said he would not rule it out, and that it would be difficult to see this in a MRI.

I am just wondering if anyone has experienced this, or know anything about it.

As always, and insight would be most greatly appreciated.

Thank you kindly in advance

[Jim Scott]

Hi Damian ~

I'm not a doctor and just speculating but your mother may be suffering from a condition known as hemifacial spasm   This link will take you the NINDS website that explains the condition better than I ever could.  http://www.ninds.nih.gov/disorders/hemifacial_spasm/hemifacial_spasm.htm  Of course, the actual diagnosis has to be rendered by a trained, licensed physician.  I'm simply offering what may be pertinent information that could be helpful to you. 

Jim 

[damien8]

Hi Damian ~

I'm not a doctor and just speculating but your mother may be suffering from a condition known as hemifacial spasm   This link will take you the NINDS website that explains the condition better than I ever could.  http://www.ninds.nih.gov/disorders/hemifacial_spasm/hemifacial_spasm.htm  Of course, the actual diagnosis has to be rendered by a trained, licensed physician.  I'm simply offering what may be pertinent information that could be helpful to you. 

Jim 

Hello Jim,

Thank you for the info, and my apologize for the delayed reply.

Is this art of the AN, or something separate. Do you happen to know?

Are there any tests she can undergo to look into this further?

Thank you again,



Damien

[satman]

i can only speak from what i experienced , my tumor was pushing on
nerves and this caused loss of hearing,balance issues ,blurry vision, facial twitching,the dizzys,headaches and a wosh wosh sound in my left ear .
but this tumor was huge [8 cm]

[damien8]

Here are the results from the first test she had:

FINDINGS:

There is a lesion filling the left internal auditory canal (IAC) measuring 11 x 6 x 5mm. The lesion is low to intermediate signal on T1 and low signal on T2. No definite cochlear or vestibular involvement is identified. No significant extension is seen into the CP angle cistern. The appearance is consistent with an intracanalicular acoustic schwannoma. The right sided IAC is within normal limits in appearance.

There are few very small (2-3mm) foci of bright signal on FLAIR and T2 within the cerebral white matter seen scattered within the frontal subcortical white matter and right corona radiata. The brain parenchyma is otherwise unremarkable. There is no evidence of hydrocephalus. The visualized intracranial flow voids are unremarkable. No acute abnormality is seen on diffusion weighted imaging.

There is a 7mm synovial cyst along the medial aspect of the left temporomandibular joint.

There is a mild diffuse cerebral atrophy.

IMPRESSION:

Left sided acoustic schwannoma as described. Further assessment with a repeat MRI study with gadolinium enhancement is recommended to best assess the extent of the lesion. This will require new requisition to be submitted.

Minimal scattered nonspecific foci or bright signal on T2 within the cerebral white matter. Mild cerebral atrophy.

Incidental synovial cyst along the medial aspect of the left temporamandibular joint. This should be confirmed as cystic on the post gadolinium study.

[mk]

There are quite a few here with facial schwannomas, and I am sure they will chime in soon. From what I have seen in this forum, it is uncommon for acoustic neuromas to cause facial twitching, so the symptoms that you describe point to a facial neuroma. But your doctor is right that it is not possible to tell just from the MRI. The vestibular and facial nerves run parallel inside the IAC and MRI imaging is not conclusive. A facial neuroma is usually confirmed  by histological analysis after surgery. For all practical purposes the treatment method is similar, but of course the risks to the facial nerve are greater with a facial schwannoma.

Marianna

[leapyrtwins]

Damien -

this could just be a side-effect of the AN.

Inside the inner ear canal are the hearing nerve, the balance nerve, and the facial nerve. 

Your mom's AN might be pressing on her facial nerve.

Jan

[nteeman]

FWIW, it was not until I had facial spasms that my hearing loss was considered serious enough to send me for an MRI and then the diagnosis of my AN.  I had what they call hemifacial spasms.  I have not had one since my surgery as they were caused by the AN.

Neal

[Ellenmn]

I started having major facial spasms about 4 yrs after my AN was found.

[Anomar11]

Damien,

On my diagnostic MRI for a 2 cm L AN, it read that the facial nerve was involved and a facial neuroma should be considered.  So the facial nerve can be involved, depending on how the AN is positioned.  At 6 months post treatment with cyberknife, I started having these spasms.  It then calmed down and went away around month 13.  So it did go on for about 7 months, sometimes 5 times per day, each one lasting 10-20 seconds.  Hopefully the nerve will calm down for your mom.  Mona

[elliemae]

Damien, I also have hemi-facial spasms, probably related to the diagnosed "AN".  As Marianna noted, the MRI couldn't tell in my case. The doctors told me also that only surgery could tell if my "AN" was really a "facial" neuroma.

I started with these before the AN was diagnosed, but at about the same time I started having balance problems ...  The AN wasn't diagnosed until the hearing started to go, and I was sent for the confirming MRI.

I had proton radiation therapy in Nov/Dec '08, a therapy chosen because of the probable involvement of the facial nerve. I am happy to say that my facial spasms have lessened considerably since then.  I still have them, but nothing like before where on a really bad day they occurred at least once an hour, if not more frequently.  Always worse when I was tired or anxious (which is still when I tend to get them).

Hopefully, whatever treatment is chosen will help.
Elaine

[Goldie]

Hi, Damien.  A bit late to chime in, but I also had facial spasms that progressed to be severe.  My doctors also could not tell from the MRI if it was a tumor originating from the facial nerve or the auditory nerve.  I did end up having translab surgery, where they discovered it was an AN pressing on my facial nerve.  Although I occasionally do get a little tightness in my face yet, the spasms stopped with the surgery.  I had a great outcome from surgery and hope your mother can find some answers soon.  Please keep us posted!

Denise D.