Lower lip twisted. What can be the cause?

[BarryLyndon32]

Hello, I notice since last year as my lower lip is increasingly twisting. If I close the mouth the lip is twisted to one side and put a little inward. I can change the position of the mouth and put it straight but I notice it's an unnatural position and I have to be constantly focused to keep it straight. Looking at photos  of a few years ago I see that already had slightly twisted.

I thought of multiple causes and factors leading to this, but I am not sure about none.I put them below:

* I am a smoker for 20 years and the truth is I press so much my lips when I smoke
* I have a very strong bruxism both day and night and a malocclusion class II Although as much as I looked I did not notice the crooked jaw and face, only lip
* I had surgery Eagle Syndrome 10 years ago Styloid taking off so I thought maybe I could have some nerve damage face
* I have been injected with Botox masseter an attempt to reduce bruxism
* I have injected relievers block a few times the glossopharyngeal nerve and the great auricular nerve. It did not work
* I've spent years in therapy with Anafranil and Topamax by chronic pain. I also thought it could be a side effect of some of these drugs

I have not had other symptoms related to paralysis, or watery eyes or difficulty of movements of the face of any kind, just maybe I was a little insensitive  area of operation of the styloid process

Does anyone have any idea of what might happen to me?

I am quite concerned and it is causing me quite complex physical

At what specialist should I go? Neurologist ? Maxillofacial surgeon ?
...
Please help me

Thank you so much

[BarryLyndon32]

I've gone back to the neurologist today. The result of the MRI is correct.
I have improved somewhat from what I'm taking clonazepam. My neurologist says it's all because of clomipramine is causing me dyskinesia. While taking clomipramine should I take clonazepam, although it would be best to change antidepressant. I hope to continue to improve and that the diagnosis is correct

[caregiver222]

Well, according to the internet dyskinesia is permanant, however that is incorrect. I took care of a patient who developed severe dyskinesia secondary to inappropriate prescribed respiridol. After discontinuance of the drug the dyskinesia resolved in eight months.

[BarryLyndon32]

Hello, thank you very much to both of you for your answers.
I visited a neurologist, his diagnosis was dyskinesia caused by medications. I've been taking topiramate and Clomipramine for many years and am currently in the process of withdrawal of both.

It is a diagnosis that does not convince me because i have understood the dyskinesia are involuntary movements. I do not notice my continuous movements of mouth or lip, just what happens is that my lip is in that position comfortably and unconscious. I am able to place it in the correct position easily.

It is quite true that i allways move the jaw and play with her and my teeth, but I allways thought it was because of bruxism

What do you think ? Can it be dyskinesia correct diagnosis?

He sent me take clonazepam for a while and has sent me a brain MRI

Thanks

[caregiver222]

The liklihood this is a cranial nerve palsy. What is unclear is the etiology of the palsy. Yes, botox could be the cause. Usually the disfiguration resolves by itself in one to three months. Your problem is a limited variation of Bell's palsy. A neurologist should be able to provide helpful, but usually there is not much to do. They used to suggest prednisone, but it isn't that helpful. You have my sympathies.

[tschock]

Wow! That's a lot to go through.
It's quite possible that you had a mild stroke somewhere in the past.
It's also quite possible that the botox may have caused this.
There are many possibilities.
I would suggest seeing the neurologist first, and see what he/she recommends.