Why a twitching lip could be more than stress and an early sign of parkinson’s disease

Neurological causes of lip twitching: Don't dismiss lip twitching when it's rhythmic and appears at rest. In some people, this subtle facial movement could be the nervous system’s quiet way of signaling early Parkinson’s (Image: Canva)

A twitching lip might seem like a constant irritant. But for some, especially older adults, it could be an early sign of an underlying neurological disorder. Parkinson’s disease, a progressive condition that affects movement, can begin with subtle symptoms, including involuntary lip tremors.

Most people experience occasional lip twitching, often triggered by stress, tiredness, or high caffeine intake. It’s usually harmless and passes quickly, says Dr Darshan Doshi, Consultant Neurologist at P.D. Hinduja Hospital & MRC. “However, when twitching becomes regular, follows a rhythmic pattern, or starts to interfere with everyday life, it may be a red flag," warns Dr Doshi.

He adds, “Lip twitching, especially when it's rhythmic and appears at rest, shouldn't be dismissed too quickly. In some people, this subtle facial movement could be the nervous system’s quiet way of signaling early Parkinson’s. Differentiating normal twitches from signs of disease is crucial.”

Also read | Parkinson disease: Causes, symptoms and treatment strategies for this neurological disorder

Parkinson’s disease is caused by the gradual death of dopamine-producing cells in the brain’s substantia nigra. Dopamine is essential for smooth, coordinated movements. Its shortage leads to disruptions in motor control manifesting as tremors, stiffness, and slowed motion.

Dr Doshi explains, “The facial muscles are very sensitive to disruptions in the motor pathways. The lips, being involved in constant micro-movements, can reflect these disruptions early.”

Lip twitching in Parkinson’s is typically a resting tremor occurring when the face is at rest. “It often starts on one side of the face and gradually worsens. The basal ganglia, another key brain region, also becomes impaired, further disturbing motor signals and leading to involuntary muscle twitching,” he says.

Dr Doshi shares early warning signs that link lip twitching to Parkinson’s. “Parkinson’s-related lip twitching typically follows a rhythmic pattern (4–6 Hz), starts on one side, occurs at rest, and persists slowly,” he says.

Also read | Parkinson's disease: Medications, deep brain stimulation, physical therapy are treatment options

It's often accompanied by other signs such as a masked facial expression, slowed movement (bradykinesia), jaw stiffness, speech or swallowing difficulties, shrinking handwriting (micrographia), balance issues, and tremors in the hands or limbs.

Other causes:

Not all lip twitching is linked to Parkinson’s disease. Common non-Parkinson’s causes include stress and anxiety, which can lead to temporary muscle spasms, and fatigue or lack of sleep, which may trigger facial twitching. “Excessive caffeine or stimulants can overstimulate the nervous system, causing involuntary movements. Some medications may list tremors as a side effect. Neurological conditions like essential tremor, which is distinct from Parkinson’s, and hemifacial spasm, involving one-sided facial muscle contractions, can also cause similar symptoms,” lists Dr Doshi.

If lip twitching continues for weeks, worsens, or appears alongside other unusual signs, consult a neurologist. “Persistent twitching with accompanying signs, like slowed movement or balance issues, warrants a thorough neurological evaluation. A proper diagnosis may include physical exams, medical history, medication trials (like levodopa), and sometimes brain imaging to rule out other conditions,” says Dr Doshi.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.