Tics, Unintended Facial Movements. Tics are unusual nervous twitches in the face, caused by spasms of local facial muscles. Some twitching can be stopped at will, but others are entirely uncontrollable. Tics are not serious when they represent temporary excessive nervousness, but when they become persistent, they may represent serious underlying disease. They most commonly involve the face about the eye, nose, and mouth.
Tic Douloureux is a well-known type of tic usually seen in the later years of life. It is very painful, strikes without warning and usually affects only one side. It produces a savage lancing pain in the temple, jaw, or teeth, and is sometimes brought about by the slight stimulation of shaving, exposure to cold or draught, and sometimes without any stimulation at all. The pain usually does not last long, it may recur with agonizing frequency.
Fig. 21. Tic Douloureux, facial neuralgia, trigeminal neuralgia are one and the same difficulty. Savage pain in one side of the face may begin with a mild trigger action, such as shaving, a cold breeze or light touch. Pain is caused by a nerve defect of the fifth (trigeminal) cranial nerve; cutting this nerve is sometimes necessary for relief. Attacks may stay away for years at a time.
Tic Douloureux involves a cranial nerve, which is the nerve of sensation to the entire face, teeth, nose, and eyes. The exact cause of this painful disease is unknown but medical and surgical measures, in the hands of the physician, are definitely available for adequate relief.
Facial Palsy. Paralysis of portions of the face is very common. Palsies of only one side of the face, frequently occur as a result of exposure to cold, or extreme emotional disturbances. They may accompany an impending or recent stroke, especially in the older age group and they may also be accompanied by paralysis of some other portion of the body.
Another type of facial palsy is called Ptosis of the eyelids and appears as an eyelid which opens only partially. Ptosis of the eyelid, especially when confined to one side, may be associated with more serious underlying disease. An example is Horner’s Syndrome, a most complex difficulty, involving not only the eyelid, but other complex body structures as well. Only a skilled physician can recognize and prescribe the necessary treatment for such difficulty.