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Hemifacial Spasm

Definition

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

Causes    TOP

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

  • A blood vessel pressing on the facial nerve
  • Tumor
  • Facial nerve injury
  • Bony or other abnormalities that compress the nerve

Muscles of the Face

Muscles of the Face
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Hemifacial spasm is more common in middle-aged and elderly women. It may have differing incidence rates in different ethnic populations.

Symptoms    TOP

  • 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

Diagnosis    TOP

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 scan or CT scan.

Treatment    TOP

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

Medication

Your doctor may recommend antiseizure medications to help relieve symptoms.

Botulinum Toxin Injections

Injecting botulinum toxin into the affected muscles can stop eyelid spasm for several months. These injections must be repeated, usually several times a year. Botulinum toxin injections are the treatment of choice.

Surgery    TOP

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.

Prevention    TOP

There are no current guidelines to prevent hemifacial spasm.

RESOURCES:

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov
National Organization for Rare Disorders
http://www.rarediseases.org

CANADIAN RESOURCES:

Canadian Movement Disorder Group
http://www.cmdg.org

References:

Alexander GE, Moses H. Carbamazepine for hemifacial spasm. Neurology. 1982;32(3):286-287.
Chaudhry N, Srivrastava A, Joshi L. Hemifacial spasm: the past, present, and future. J Neurol Sci. 2015;356(1-2):27-31.
Defazio G, Martino D, Aniello MS, et al. Influence of age on the association between primary hemifacial spasm and arterial hypertension. J Neurol Neurosurg Psychiatry. 2003;74(7):979-981.
Digre K, Corbett JJ. Hemifacial spasm: Differential diagnosis, mechanism, and treatment. Adv Neurol. 1988;49:151-176.
NINDS hemifacial spasm information page. National Institute of Neurological Disorders and Stroke website. Available at:
...(Click grey area to select URL)
Updated October 11, 2011. Accessed July 11, 2013.
Last reviewed May 2016 by Rimas Lukas, MD
Last Updated: 5/30/2014

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