Lip Twitching (Persistent, Once Off) Causes and Diseases

Twitching of the lip is not usually seen as a serious condition if it occurs once-off and most of us will experience such an episode every now and then in life. Often these episodes are due to innocuous causes like stress and emotion, large amounts of caffeine or even with certain nutritional deficiencies. It arises suddenly and resolves quickly with no lasting effect.

While these cases of lip twitching are not a cause for concern, frequent episodes or persistent lip twitching needs to be investigated because it may be due to underlying diseases even when other symptoms are absent.

What is lip twitching?

Lip twitching is where the muscles of the lip contract involuntary leading to a trembling of the lips. It is also known as fasiculations and may be associated with spasms, tics or tremors. The problem is usually due to the an irritation or overactivity of the nerve supplying the lip muscles but can sometimes also arise with muscle problems even when the nerve is otherwise healthy.

Why do the lips twitch?

Normally muscles contract when stimulated by the nerves and relax once this stimulation ceases. The strength of the contraction depends on the strength of nerve signals. However, in twitching the muscle contractions are sudden and rapid thereby giving the sensation or appearance of the lip trembling. It is not always visible but can be felt by a person who is experiencing these twitches.

Anxiety, stress, fatigue, dehydration, stimulants like caffeine, illicit drugs, alcohol excess and the withdrawal of certain addictive substances may all affect nerve and/or muscle activity to lead to temporary twitching. This type of temporary twitching often resolves spontaneously or with minimal supportive measures and may not occur thereafter once the causative factor is removed or corrected.

Types of Tremors

It is important to understand some of the types of tremors when looking at twitches in general.

  • Essential tremors are the most common type and is usually seen with physical activity or stretching. It tends to involves the head, arms and hands most often. There may be no known cause and sometimes there is a family history of these tremors. It is also associated with certain neurological disorders. Essential disorders are mild during inactivity, often disappear completely during sleep and are at its peak during activity. It can even lead to uncontrollable shaking of the body parts.
  • Drug-induced tremors, as the name suggests, arises with substance abuse including alcohol and illicit substances (street drugs). The tremors are also often seen as part of withdrawal symptoms not only with alcohol and illicit substances but also with certain pharmaceuticals like opioid painkillers. The tremors may affect many parts of the body include the voice box, tongue, lips and even the entire head.
  • Hysterical tremors is associated with emotional states like intense fear, sadness, anger and sometimes even joy. It is usually short-lived and subsides once the emotional state stabilizes.
  • Pill-rolling tremors are characteristic of Parkinson’s disease, a neurodegenerative disorder that leads to slowness of motion. These tremors are sometimes the first symptoms that appear.

Causes of Persistent Lip Twitching

Most of the time lip twitching is due to nerve abnormalities. For some reason the nerve may be abnormally stimulated or irritated leading to the lip twitching. Sometimes the muscles of the lips start twitching even without the concomitant nerve stimulation, like when there is muscle fatigue.

Facial Palsy

Facial palsy simply means paralysis of the face due to some disruption of the facial nerve. It can be temporary or permanent One of the more common temporary causes is Bell’s palsy while a stroke can cause a permanent facial palsy. It is often one-sided depending on which of the two facial nerves are affected. Typically it appears with drooping of the face on one side but twitching may sometimes be noticed in certain areas like the lips.

Hemifacial Spasm

Hemifacial spasm is a condition where there is twitching or tics of the face and the lips may also be affected. These involuntary movements are due to some irritation, injury or compression of the facial nerve. It can be caused by a tumor that presses on the facial nerve but at times there may be no known cause. Although it can worsen with fatigue or anxiety, these are not causes of hemifacial spasm.

Facial Tics

A tic is any repetitive movement associated with repeated contraction of certain muscles. When it occurs exclusively on the face then it is known as a facial tic. Sometimes it arises on its own with no clearly identifiable cause and then resolves spontaneously after a period of time. At other times in can persist for long periods and even throughout life. Stress is known to worsen the tics but is not a cause of it.

Tourette’s Syndrome

Tourette’s syndrome is a neurological disorder believed to be associated with genetic factors or abnormalities with brain hormones (neurotransmitters) but the exact cause is still unknown. It is marked by sudden and unwanted movements or sounds that arises for unknown reasons. It may also be associated with behavioral problems.  Tourette’s syndrome usually starts in early childhood and while tics are present it should not be confused with facial tics.

Parkinson’s Disease

Parkinson’s disease is a neurodegenerative disorder where certain nerve cells that produce the chemical dopamine die off. It leads to slowness of motion known as bradykinesia. A pill-rolling tremor is a common symptom of Parkinson’s disease and involves the fingers. Lip twitches or tremors may also bee seen. Typically these tremors arise at rest but tend to disappear when asleep. Activity also seems to stop the tremors.


Hypoparathyroidism is a condition where the parathyroid gland is underactive. These glands play at important role in regulating the levels of calcium and phosphorus in the body thereby contributing to bone and teeth strength among other functions. In hypoparathyroidism the levels of calcium drop while the levels of phosphorus rise in the body. These minerals also play a role in muscle contraction and nerve activity and twitching may arise as a symptom.

DiGeorge Syndrome

DiGeorge syndrome is an uncommon genetic condition where the development of different parts of the body is impaired. It arises as a result of a defect in chromosome 22. The condition is present from birth although sometimes the symptoms may be seen to develop later in life. It includes a cleft palate, heart defects, underfunctioning parathyroid glands and behavioral symptoms. Twitching is just one of the many symptoms that are present.

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