lopsided smile

[Moonmark]

Hi, everyone--

I hope you all had a nice Thanksgiving. I have yet another question. I was visiting my family yesterday for the holiday and my sister took out some pics that were taken a few weeks ago at another event. I noticed that in all the pics where I am smiling, that my smile has become slightly lopsided on the lower lip. the lower lip on the right side does not pull back in the same way as the other side, giving my overall smile a slightly "lopsided" appearance. I was somewhat aware of this, but I guess I was startled to see how noticeable it was in all the pics.

this is the area of my face where I have had the most persistent twitching. this is also the side of my face where I have had some saliva seep out of the corner. very slight, but enough to cause a small infection there a few months ago.

I have only noticed this smile thing recently, but I did mention the saliva issue to the neuro in Sept. he said I did not have tongue fasciculations and tried prying my lips apart with his fingers and said my "lip seal" seems pretty good. not sure what to make of this. I am due to go back in Dec.

does anyone recall having any early mild lip weakness which affected your smile and caused some seepage, before you had any slurring or anything.

my stats: negative EMG on two legs and one arm in June. brisk reflexes of 3-plus. symptoms of off- and on- twitching, off- and on- excess saliva, muscle weakness, and some off- and on- muscle pain, for 8 months or so. a few recent episodes of coughing/choking on liquids, a chronic daily cough, especially after eating. weird episode of muscle pain (cramping?) in the chest area the other day (that was a first). first neuro said in June no ALS at this time, six month follow-ups; second opinion neuro said ALS unlikely, but requested three-month follow-ups. Both specialists in ALS. both said they could not definitively rule out a neuro condition, however.

what would you be asking at my next appt? should I push for an EMG of face area-- is that really painful? a second EMG of limbs? six months will have elapsed since the first. do you think that is adequate time for things to have changed on the EMG, if, in fact, they are going to change? should I be looking elsewhere for a diagnosis, other than from a neurologist?

any thoughts/suggestions appreciated.

thanks-

Sandra

 

[rose]

Sandra,

I would not worry too much about a lopsided smile. I have photos of me as a baby with a crooked grin. Are you able to curl your lower lip over your lower teeth and "bite down" with your upper lip? Can you whistle? If you pucker your lips as if to give that darling daughter a kiss, does your lip pucker evenly, or are there gaps where the skin is smooth instead of crinkled? Can you hold air in puffed cheeks? These are common ways lip strength is measured. When you relax your mouth, (give it a while, go do something instead of just waiting for it to relax) are the corners of your mouth still adequately touching each other? (my left side droops down at the corner and stays open).

To answer your question as to whether emg of face is painful; it should not be. The needles used are quite fine.

As for if you should be looking elsewhere, what did the last doctor you saw suggest? Watch and wait? ... See another specialty such as infectious disease specialist or endocrinologist? Your best guidance would almost have to come from the doctor who examined you and ordered/interpreted you test results.

December is not far away now, get that list of questions ready for your neuro!

(HUGS)

 

[Al]

A couple of people have recently asked me if I am unhappy because I appear not to smile much anymore. I looked in the mirror closely. My mouth is drooping more making for an unsmiley face. It's more of an effort to smile now due to I guess bulbar symptoms starting. My granddaughter and DIL are here from the Phillipines and son comes home Dec. 15 so I'll just have to put more effort into smiling.

AL.

 

[GlenBrittle]

If I do not make a conscious effort only the right side smiles. I can still force the left side.

Glen

 

[rose]

Al, my face also looks the most different when relaxed, rather than smiling. It does take more effort and I can look more like I'm snarling now. Here's a "before" shot of my lips while smiling... second one was taken recently. (True I was making an effort to hold the left side up.)

Al, glad you've got your family in!

 

[GlenBrittle]

Rose, its still a pretty smile.

 

[GlenBrittle]

Ok , anyone that feels embarassed about their facial features , compare to this one.

Yep , you are doing ok.

 

[Erica]

Glen, actually very adorable and cute!
Rose, what can I say. .... A lot of movies stars would kill for such beautiful smile!

 

[Al]

You're still a cutie in my book Rose.
Glen, that's a different story now.

AL.

 

[handinhand]

My drooping mouth was what got me to the emergency room. My daughter thought I was having a stroke with my slirring and the side of my mouth drooping. So, It can be one of the first signs... I thought I was lucky not to be having a stroke and only had something called ALS..... ? not for long though..... My smile looks fake to me now. I also think I look like Howdy Dooty..... At night I am starting to drool from one side of my mouth..... It is hard to see these things happening. Little by little though, thank goodness for that.... I wonder if we could have a face lift? LOL HUgs, Linda

 

[rose]

Linda,

Despite what these kind people have said, (thank you!) my lips have changed so much. In the beginning I kept biting my lip and the insides of my mouth because it was like the skin was falling inside my mouth, as if it was caving in. I lost bulk to the lips as far as "pouf" goes, (who knew there is so much muscle in a lip!) that I asked a plastic surgeon who I knew socially if he would try injecting them with restylane. He wouldn't do it. He actually contacted the manufacturer, who said there were no contraindications for someone with ALS, but he still said that if I were his sister he'd say not to do it. I'm still always shocked when I catch sight of myself in a relaxed neutral expression.

Sandra, I can't find my baby picture with the crooked smile. I'm sticking a couple on here for the "boys" on the forum who like topless blondes though. :wink:

 

[KeeKer]

Rose, you're gorgeous at any age. And truthfully I don't really see any difference in the smiles. I think it all depends on what you concentrate on when you look in the mirror.

 

[Zaphoon]

I spent 3.5 years on recruiting duty for the navy and one of the fellows I worked with walked in the office on a Monday morning with one side of his face down and the other side up. He looked like something out of a Batman episode.

Anyway, he went to the doctor and the doc told him he had Bell's Palsy. The other guys always called this poor sailor "Bucket Head" because of the shape of his noggin. I digress...

The Bell's Palsy eventually went away and the fellow's face returned to normal.

Zaphoon

(Glen, your photo reminds me of my first crush!)

 

[rose]

Colleen, that was my point about lips during a smile not looking so obvious. (I can tell, of course.)

.... So this is my mouth this morning, sitting here at the dining table writing this. Mouth is relaxed, teeth together. I wanted to reassure you guys that I don't walk around looking like this, but I guess I really do unless I'm consciously trying to keep my face shored up LOL.

The previous smile photo is reversed because I snapped it looking into a mirror. I'd gotten a new haircut and was sending a pic to my sweetie for him to see. I didn't think about how my smile was "flipped" til I saw it this morning.

 

[Zaphoon]

Rose,

I suppose you could call it a "sympathy" crush. Besides being homely to the point of looking manly (okay, beyond manly, perhaps pathetic), the poor dear was also overweight and a bit stinky but she had a sweet disposition.

Hey, it was my opportunity to be a knight in shining armor for someone and I was 7. My taste would take a turn at 8 when she moved out and a pretty red-headed girl moved in.
She looked like a movie star, used Dial soap and Breck shampoo. Those were the days!

SGPPZ