There actually is a type of facial twitch that’s associated with multiple sclerosis.

However, this data needs to be picked apart very carefully, which is why the statement, “A twitching nose can be an early sign of MS,” is flawed.

First off, ask yourself where you got the idea that a twitching nose might be a sign of multiple sclerosis.

Muscle spams that are involuntary are common with MS.

What is termed “muscle spasm” is not necessarily the same as a “twitch” or fasciculation.

A muscle spasm can hurt. It is uncontrollable, of course, and is a jerking motion of the extremities.

So you should not just assume that a spasm in a leg or arm means the same as a twitch in the nose.

Googling for Answers

A symptom list for MS might include “facial muscle twitching.” This doesn’t mean the nose as a solitary location.

People who are freaking that a new-onset twitch in their nose is MS have invariably spent a lot of time googling about this.

Multiple Sclerosis Can Cause Facial Twitching

There are two kinds of muscle twitching: fasciculations and myokymia. In the Postgraduate Medical Journal, the authors admit that these two conditions “have been confused in the past.”

Fasciculations and myokymia are NOT one and the same.

“Continuous facial myokymia in MS is caused by a pontine tegmental lesion involving the postnuclear, postgenu portion of the facial nerve.”

This is an excerpt from Arch Neurol. 1994 Nov;51(11):1115-9 off the site. We don’t know if “facial” encompasses the nose.

This also comes from pubmed, originating from the journal European Neurology (2000;43(3):137-40):

“Continuous facial myokymia is an involuntary undulating, vermicular [worm-like] movement that spreads across facial muscles and is associated with a characteristic electromyographic pattern.

“It is an infrequent clinical sign that almost always occurs in intrinsic brainstem lesions, particularly in multiple sclerosis (MS).”

• It “spreads across facial muscles,” which is different data than “My nose keeps twitching.”

• “It is an infrequent clinical sign.” At least it’s not common, but we still don’t know if the nose is ever involved in facial myokymia.

• Did you catch another key word? “Continuous.” Does your nose twitch continuously? If it does, don’t panic yet.

MS, Myokymia and Twitching Noses

There is a report called “Facial myokymia: a clue to the diagnosis of multiple sclerosis,” in the Postgraduate Medical Journal (November 1972) 48, 657-661.

From 1969 to 1971, there were found only “forty cases [with facial myokymia] reported in the world literature and added two of their own,” states the paper, referring to numerous MS researchers.

The paper continues: “Of these cases, in twenty-three the diagnosis of multiple sclerosis seemed ‘well established, or at least quite likely’ and at least ten had intrinsic pontine tumours.

“Thus, over half the reported cases [of facial myokymia] have been associated with multiple sclerosis.”

WAIT…Wait…do not panic over “tumours.” This report states that a tumor that causes facial myokymia also causes significant facial weakness and paralysis! So if your only problem is a twitching nose, you can relax.

The report is lengthy, but here’s another excerpt:

“Only single cases or very small series of patients with facial myokymia have so far been reported in the literature.

“Among the most noteworthy of these is the report of Anderman et al. (1961) who described four personal cases and found seven in the literature.

“Matthews (1966) described six patients and found twelve in the literature, and the condition was reviewed in the British Medical Journal (1966).

“Gutman et al. (1969) described two patients and found forty in the literature. From these reports facial myokymia emerges as a rare phenomenon with distict [sic] characteristics.”

You should be asking yourself, “What are the odds that my twitching nose is a sign of multiple sclerosis?”

Another excerpt is as follows: “The relationship of facial myokymia to multiple sclerosis is important.

It is clear that in the twenty-three patients in the literature and in the present three cases that a causal relationship obtains [sic].

“In the vast majority of patients in whom facial myokymia has been transient and in whom there has been no significant facial paresis, the phenomenon has been associated with multiple sclerosis.

“The nature of the pathological process in the few without clinical evidence of multiple sclerosis remains obscure.

“It is of course possible that these patients too may suffer from multiple sclerosis, the myokymia being the first evidence of demyelination.

“Most of these patients are in the age-group most vulnerable to multiple sclerosis, but further episodes of neurological disease have not appeared in periods varying from 5 to 6 years in three of Matthews’ patients.”

You should be asking yourself, “What are the odds that my twitching nose is a sign of multiple sclerosis?”

Even if you consider yourself a very unlucky person, being that 400,000 people in the U.S. have MS, do you realize just how astronomically small the chances are that your twitching nose is due to this disease?

And besides, you don’t EVEN KNOW if the twitching is actually myokymia.

Final Verdict

Does MS cause twitching in only the nose?

“Nose twitching is unlikely, but MS can cause mouth and eye twitching if the inflammation affects the area of the brain responsible for face movements,” says Achillefs Ntranos, MD, a board certified neurologist specializing in multiple sclerosis and demyelinating diseases, and chief neurologist with Treat MS.

“Of note, eye twitching alone is most commonly due to stress, anxiety or high caffeine intake.

“If the eye and mouth are twitching together then a brain MRI should be done to evaluate for MS inflammation.

“MS can also cause tremors that can affect the arms, hands or legs.”

Dr. Ntranos is the chief neurologist and MS specialist at Treat MS. His goal is to combine concepts of personalized medical management with evidence-based clinical decision making to maximize the treatment benefit for each MS patient.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 
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