Developed an annoying lip twtich

Hi all

First time poster on here

For the last few months my face has been twitching off and on, the twitch is on the right hand side of my mouth where your lips meet. It twtiches up every now and then.

For the last few weeks its become more agressive and twtiches maybe every 10 seconds or so and you can actually see it.

Does this sound like something that could be the start of PD? I have blood tests arranged for Friday ad my Dr does not seem overly concerned but of course when you google things like this it brings you to PD.

I appreciate no one can diagnose me on here, i am just curious to know if PD can start this way?

Hello @chris_uk and welcome to the forum community.

I am sure some of our friendly and helpful members will be along to share experience and offer support soon.

Parkinson’s symptoms can vary a great deal from person to person so it’s important to discuss any concerns with a health professional.

If you haven’t already you might like to have a look at our website where we have information on symptoms and getting a diagnosis may be a good place to start.

You could also make contact with our free helpline on 0808 800 0303 or email us at [email protected] Mon-Fri 9am-7pm Saturday 9am-2pm. Our trained helpline advisers can provide information and support on all aspects of life with Parkinson’s and, if appropriate they can even arrange for a Parkinson’s nurse to contact you for a chat.

I hope you find this information helpful.

Best Wishes

Moderation team

Hi. I’ve never heard of anyone having this symptom as the start of PD. Incidentally, there is no blood test for PD.

Hi, I have the lip twitch but that said it was the last thing to develop.
I have a complete right sided tremor and mine started nearly 3 years ago with a finger twitch!
As it has been mentioned everyone’s symptoms vary and their journey is completely different.
Try not to dwell, easier said than done I know!
Hope it all goes well and let us know the outcome if you can.
Take care

Hi thank you both for you’re replies :slight_smile:

Yes i know they cant test for PD with a blood test, as far as i know PD is not even on my Dr’s Radar i think they are just doing blood tests as first step to see if i am low on anything i guess.


Antipsychotic Drug-Induced Movement Disorders Pierre J. Blanchet Can.J.Neurol.Sci. Feb.2003

Very early in the process of diagnosing abnormal involuntary movement (AIM) disorders, one can be rewarded by keeping a high index of suspicion for possible drug-induced causes, not only through a complete list of current medications, but also identification of the drugs the patient used to take and other possible offending medications that might be available from family members and other sources.

Among drug-induced movement disorders, antipsychotic drugs and other dopamine receptor blocking agents occupy a central place. Movement disorders [are also] caused by antidepressants, lithium, antiemetics, antiparkinsonian agents, anticonvulsants, calcium channel blockers, sympathomimetics and others.

My timeline: Onset of abnormal involuntary movements

Oct/Nov. 01 Domperidone 1 anti-emetic for migraine with vomiting
Feb.02 I develop muscle spasms around my eyes
15/5/02 Sertraline 13 days abnormal involuntary movements begin to spread
27/5/02 Amitriptyline 2 days
22/8/02 my letter to my GP …Lot of movement around mouth, jaw, lower face, tightness in neck and shortness of breath Increased head jerking when wanting to open eyes
Sertraline Patient Information Leaflet. 2002: A side effect of uncontrollable twitching is more likely if the patient is already experiencing symptoms.
Prozac Backlash JOSEPH GLENMULLEN 2000 Simon & Schuster

“Something dreadful is happening to me,” she said. “I need to see a neurologist. My lips are twitching and my tongue keeps darting out of my head.”… I was flabbergasted to see Maura’s symptoms firsthand. Her lips now displayed twitching similar to that which I had observed around her eyes. But worst of all was the tongue-darting: fly-catcher-type movements in which her curled tongue darted in and out. The tongue-darting together with the twitching was disfiguring.
“I believe this is a medication side effect…Tardive dyskinesia. “

Pathophysiology of Levodopa and Dopamine Blocking Agent-Induced Disorders A.B. Acharya, C.A.Faber, R.Pahwa, K.D.Sethi (In: Sethi K, ed. Drug-induced movement disorders. New York: Marcel Dekker, 2004.)

p.280 Movement disorders caused by dopamine antagonists include parkinsonism, tardive dyskinesias, and akathisia. Long term use of L-dopa results in the development of dyskinesias in a majority of the patients with PD.
DIMD still presents a serious challenge for the clinician. In some patients DIMD can be more disabling than the symptoms related to the primary illness
p.284 L-dopa-induced dyskinesias (LID) are commonly encountered among patients on chronic L-dopa therapy. Patients who develop LID have been on L-Dopa therapy for a period of several months to years. Peak dose dyskinesias occur in 30-80% of parkinsonian patients treated with L-dopa…dyskinesias induced by L-dopa in PD patients may closely resemble the movements seen in TD
Timed Stereotypies Rating Scale

Abnormal Involuntary Movement Scale (AIMS) Reference: Guy W. 1976 NIMH

Thanks but i really didnt understand any of that last reply, totally went over my head !! :slight_smile:

Just an update, for anyone reading this and having the same symptom.

The twitch near the corner of my mouth went away for about 5 days. However i am a runner and have noticed that when ever i do a longer run (20 miles on saturday) it come back after i have done this and hangs around for another few days.

Does this still sound PD related?

Hi Chris, the corner of my mouth kept twitching or pulling upwards, not sure if this is similar. My Consultant said it was a type of dystonia. xx

This is EXACTLY what mine does, so is dystonia a type of PD? sorry i am not clued up on this?

Ok after googling this i am not massively concerned, it seems dystonia is indeed related to PD.

My movement disorder began with”muscle twitches”. The most useful thing any health professional could have told me back then was that this could be a side effect of any drugs I might have taken recently and that if this was the case I should avoid any similar drugs in the hope that it would not get worse or become permanent.

You could be given blood tests till the cows come home but a simple step you can do yourself is look up any recent medication to see if it is known to cause movement disorders .
Risks and side effects of levodopa drugs: Involuntary movements (dyskinesia)
These are muscle movements that you can’t control. They can include twitches, jerks, twisting or writhing movements,

Sertraline induced mandibular dystonia and bruxism N. A. Uvais, V. S. Sreeraj, and S. V. Sathish Kumar J Family Med Prim Care. 2016 Oct-Dec; 5(4): 882–884.

Specific serotonin reuptake inhibitors have been associated with the occurrence of drug-induced parkinsonism, dystonia, dyskinesia, and akathisia.

…After 15 days at this dosage without adverse effects, the dose was increased to 75 mg/day… she started having “strange involuntary movements of the face” with “forced deviation of the jaw” to the lateral side which was extremely distressing in nature, lasting for few minutes. Tablet sertraline was reduced to 50 mg/day, and the distressing symptoms resolved. However, after 2 months, again she started having distressing movements of the face, though with lesser intensity. Along with it, she started having severe teeth clenching and associated loud grinding noises during sleep most of the day…

In this case, the patient developed mandibular dystonia and bruxism with sertraline, and there were no other medications with known effect on the dopaminergic system been consumed. The resolution of both the symptoms after discontinuation of sertraline and the Naranjo score of 6 indicates a probable causal relationship.

Drug-induced movement disorders S. R Duma, V.SC Fung, Aust Prescr. 2019 Apr; 42(2): 56–61.

Tardive movement disorders include dyskinesias (typically orobuccolingual), stereotypies, akathisia, dystonia (focal, segmental or generalised), myoclonus, tremor and tics. Additionally, tardive parkinsonism may be experienced.

Patients are often on combinations of drugs that may cause more than one movement disorder, thereby making it challenging to identify the culprit drug.

Tardive dyskinesia (TD) is a group of involuntary movement disorders caused by drug-induced damage to the brain and often associated with physical or emotional suffering. TD is caused by all drugs that block the function of dopamine neurons in the brain. This includes all antipsychotic drugs in common use as well as a few drugs used for other purposes. TD can vary from a disfiguring grimace to a totally disabling array of spasms and often bizarre movements of any part of the body.

Unless identified at an early stage and the offending drugs stopped, these disorders nearly always become permanent.

TD can impair any muscle functions that are partially or wholly under voluntary control such as the face, eye muscles, tongue, neck, back, abdomen, extremities, diaphragm and respiration, swallowing, and vocal cords.

Classic TD involves either rapid, jerky movements (choreiform) or slower, serpentine movements (athetoid). In the extreme, a patient may look as if he or she is playing a guitar in a wild rock band. He may be unable to sit or stand straight, or be unable to control constant head bobbing. Hands and feet or fingers and toes may curl uncontrollably.

A second form of TD, tardive dystonia, involves painful muscle contractions or spasms, often the neck, and sometimes leading to overall rigidity of the body.

A third form of TD, tardive akathisia, involves psychomotor agitation, an inner torture that drives the person to move about compulsively seeking relief.

I am not taking any medication for anything so that wont be what is causing this twitch when it happens

Hi Chris, I had botox for mine at Salford Royal , every 3 months and it is really helpful. I can really tell it is overdue now because obviously Out Patient appts are postponed. You have to be careful as I also had it to stop the same twitching in neck muscle and I couldnt swallow properly and ended up in hospital for a couple of days xx

Thank you for your reply, is yours related to PD ?

Hi Chris, yes it is cx

Thanks and was this your first symptom?

Hi, no , the only symptom initially was that when I was putting my make up on, I noticed the fingers on left hand didnt work the same as right hand!! Anyway, i ended up having DAT scan which confirmed low dopamine on left side,x