Health Library

Definition

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

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
  • 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

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

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
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 .

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

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

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

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

Hemifacial Spasm Association
http://www.hfs-assn.org

References:

Alexander GE, Moses H. Carbamazepine for hemifacial spasm. Neurology . 1982;32:286-287.

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;74:979-981.

Digre K, Corbett JJ. Hemifacial spasm: differential diagnosis, mechanism, and treatment. Adv Neurol . 1988;49:151-176.

Ehni G, Woltman HW. Hemifacial spasm. Arch Neurol Psychiatry . 1945;53:205-211.

Hemifacial spasm. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 11, 2013.

Hemifacial spasm information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/hemifacial_spasm/hemifacial_spasm.htm . Updated October 11, 2011. Accessed July 11, 2013.

DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#carbamazepine .



Last reviewed July 2013 by Rimas Lukas, MD; Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Baptist Flame

Baptist Health Systems

Find A Doctor

Services

Locations

Baptist Medical Clinic

Patients & Visitors

Learn

Contact Us

Physician Tools

Careers at Baptist

Employee Links

Online Services

At Baptist Health Systems

At Baptist Medical Center

close ×