by Swedish Staff and Contributors
Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions to occur in the muscles on one side of the face.
Hemifacial spasm doesn't have a specific cause. It may occur as a result of:
- A blood vessel pressing on the facial nerve
Hemifacial Spasm - Before Surgery
Hemifacial spasm is more common in middle-aged and elderly women.
- 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
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.
Talk with your doctor about the best treatment plan for you. Options include:
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.
Hemifacial Spasm - Side View
HFS Step 1
HFS Step 2
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
There are no current guidelines to prevent hemifacial spasm.