At 03:48 PM 9/25/98 +0100, Mark Trowell wrote:
>I have a problem with one of the muscles in my orbicularis occis
>(spelling?). The thing has now been twitching for over two weeks
>continuously just above my left eye. It used to do it intermittently
>before, but now it's constant with only occasional sudden pauses. It then
>builds back up to a crescendo.
>
>It's not painful, as such, just rather like having a mild stinging nettle
>being applied left hand side of my face.
>
>HELP!
>
While agreeing with what everyone else has said about more sleep and less
work etc.,
I think that the low key approach is only justified if this is an isolated
symptom, i.e. no similar fasiculation elsewhere.
Both from personal experience, from dealing with patients and from
discussing with neuro colleagues I have the impression that sensory
symptoms are rare or unusual. Is the mild stinging nettle sensation a kind
of paraesthesiae?
I never begrudge patients coming to see me with this, and I would have
thought this is a perfectly reasonable situation to see your own GP - this
is probably the only bit of formal advice we should be giving?
NB I've never considered the use of Botulinum toxin for this kind of
fasiculation. Some of my patients have had it for blepharospasm which
looks different and I've always viewed as a different diagnosis. Has
anyone specific experience of using it for troublesome orbicularis
fasiculation?
JB
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