Upper lip twitching is an involuntary contraction of upper lips caused by many conditions including emotional factors. In some cases, it may be an initial presentation of a neurodegenerative condition. It is suggested to seek immediate medical attention if your symptoms are progressive and persistent.

Causes of Upper Lip Twitching

Withdrawal from Substances

Certain addictive substances (or drugs of abuse) can produce twitching of lips after excessive intake or during withdrawal stages. These include cocaine, heroin, amphetamines and other illicit drugs. In addition, certain stimulants like caffeine or caffeinated beverages like coffee, cigarette, alcohol, aerated or soda drinks or other neuro-stimulants can also produce involuntary muscle contraction of lips, lids and oral cavity if consumed in excessive amounts.

Emotional Triggers

Lips receive nerve stimulation from autonomic nervous system which also control emotions, behavioral responses and facial expressions with the help of sympathetic nervous system. Sudden or unexpected emotions often lead to twitching of upper lips and extremities in certain cases. Twitching that is followed by emotional triggers is differentiated by pathological causes with the help of other signs of adrenergic stimulation like watering of eyes, flushing of face, dilation of pupils, inability to speak properly or non- coherence of speech.

Bell’s Palsy

Bell's palsy is a transient condition of irritation or damage to facial nerve, which is reported in the setting of genital herpes or cold sores and mostly affects one side of the face only. Bell's palsy also present with other features like swelling of face and dropping of eye lids besides twitching of upper lips. In addition, most people develop difficulty in talking, closing eye lids and pursing lips due to muscular weakness.

Essential Tremors

Essential tremor is a condition in which involuntary muscle contraction occurs as a result of neurological dysfunction. It may be associated with generalized shaking of the body and is more pronounced on hands and extremities. People develop essential tremors in their forty’s and symptoms gradually worsen over time with age, physical activity and emotional/ environmental stressors. It can also cause upper lip twitching. 

Parkinson’s Disease

Parkinson’s disease is caused by degeneration of dopamine secreting cells in the substantia niagra of brain. Besides twitching of upper lips, other features include shaking of extremities (especially hands), slurred speech and other signs of neuro-degeneration. Replacement of dopamine helps in resolution of most symptoms.

Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis is a progressive neurodegenerative condition that is marked by weakness of nerves and muscles. Twitching of upper lip and facial muscles is one of the initial symptoms after which the person gradually succumb to disabling muscle weakness and paralysis. Death usually ensues with the paralysis of respiratory muscles. The cause of ALS is mostly a genetic aberration that is inherited by either parents and is likely to be transmitted to offspring also. Other causes include biochemical imbalance in body chemicals and dysregulation of important proteins due to an autoimmune condition.

Hemifacial Spasm

Hemifacial spasm is another nervous condition that is marked by twitching of facial muscles, paralysis of motor expression muscles and rhythmic upper lip twitching. The cause of hemifacial spasm is nerve compression, facial nerve in most cases, compression of major artery by a growing tumor and in certain rare cases a brainstem lesion like stroke can also lead to hemifacial spasm.

Hypoparathyroidism

Calcium and phosphorous are tightly regulated in the blood by the action of parathyroid hormone that serves to retain most of the calcium in the bones and very little in serum for the action of enzymes and contraction of muscles. Idiopathic, iatrogenic (after thyroid surgery) or due to autoimmune destruction of parathyroid gland, the secretion or parathyroid hormone decreases significantly that present as twitching of upper lips and other muscles of the body. The effects are due to low serum calcium levels and symptoms respond well to calcium replacement.

Tourette’s Syndrome

The inherited childhood disorder that is marked by periodic or non- periodic vocal or motor tics is reported quite frequently in adolescent children. It is characterized by movement of facial muscles, twitching of upper lips, repeated blinking of eyes and other similar features. So far no exact pathology is known; however, a number of pharmacological treatments help in achieving moderate resolution of symptoms.

DiGeorge Syndrome

DiGeorge syndrome is an inherited disorder that is marked by mutation at chromosome 22. It presents with developmental defects like underdeveloped immune system due to congenital absence of thymus, heart defects, cleft palate and hypocalcemia or low serum levels of calcium that leads to twitching of facial muscles and lips in addition to tetany of limb muscles.

Treatments for Upper Lip Twitching

Treatment modalities are dependent upon the primary cause of twitching of lips. It is recommended to investigate the cause before initiating the management options. For mild twitching especially if the twitching is associated with caffeine intake mere lifestyle modification is enough to relieve the symptoms. However in situations where the cause of twitching is grave or a serious problem, periodic assessment is needed by a medical specialist. Some lifestyle modifications also help in most cases:

• Psychotherapy helps in controlling twitching of lips due to emotional factors
• Control of caffeine, alcohol and stimulants is also advised if your symptoms are getting worse.
• Calcium supplements are advised if symptoms are due to hypocalcemia.