Hemifacial Spasm

Hemifacial Spasm

Hemifacial Spasm

by Swedish Staff and Contributors

Hemifacial Spasm Defined
Causes
Risk Factors
Symptoms
Diagnosis
Treatment
Prevention

Hemifacial Spasm Defined

Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions to occur in the muscles on one side of the face.

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Causes

Hemifacial spasm doesn't have a specific cause. It may occur as a result of:

  • A blood vessel pressing on the facial nerve
  • Tumor

Hemifacial Spasm - Before Surgery

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Risk Factors

Hemifacial spasm is more common in middle-aged and elderly women.

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Symptoms

  • Intermittent twitching of the eyelid muscle
  • Forced closure of the eye
  • Spasms of the muscles of the lower face
  • Mouth pulled to one side
  • Continuous spasms involving all the muscles on one side of the face

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Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

  • Electromyography (EMG)—records electrical activity generated in muscle while contracting and relaxing
  • Angiography —uses contrast material to see blood vessels
  • Images of internal body structures may be taken with an MRI or CT scan.

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Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Medication

Your doctor may recommend antiseizure medications to help relieve symptoms.

Botulinum Toxin Injections

Botulinum Toxin Botulinum toxin (or Botox) can be an effective treatment option for Hemifacial Spasm.

Botulinum Toxin is injected under the skin causing  the facial muscles to relax. While these injections can be effective for Hemifacial Spasm, the effect is temporary and typically lasts 3 to 6 months. Complications can include temporary lid drooping and minor bruising at the injection sites.

Surgery


Hemifacial Spasm - Side View


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Microvascular decompression surgery repositions the blood vessel away from the nerve. This is successful in cases of hemifacial spasm where the cause is suspected to be a blood vessel compressing the facial nerve. When medications and injections fail to control spasms, Microvascular Decompression can be a long-term solution to relieving the nerve compression eliminating the spasm. A neurosurgeon makes an opening in the skull (craniotomy) at the back of the head to expose the facial nerve at the brainstem. The surgeon will locate the blood vessel compressing on the nerve and place a special Teflon sponge between the nerve and the blood vessel relieving the pressure and preventing the spasm.

Following the Microvascular Decompression procedure, the neurosurgeon closes the opening and you will be awakened and allowed to recover from anesthesia. Once this pressure has been relieved, patients often report immediate and complete relief from the spasm. Most people stay in the hospital for observation for one to two days.


Hemifacial Spasm - After Surgery

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Prevention

There are no current guidelines to prevent hemifacial spasm.

RESOURCES:

CANADIAN RESOURCES:


 

Diagnosis and Treatment

For more information:

Cerebrovascular Center