Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions to occur in the muscles on one side of the face.
Hemifacial spasm is believed to be due in part to compression of the facial nerve where it meets the brainstem. The compression can be cause by:
- A blood vessel pressing on the facial nerve (most frequent cause)
- Facial nerve injury
- Bony or other abnormalities that compress the nerve
Muscles of the Face
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The following factor increases your chance of developing hemifacial spasm:
- 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, and perform a physical exam. Tests may include the following:
Hemifacial spasm is usually a chronic condition. Remission of symptoms, although possible, has only been noted to occur in less than 10% of patients.
Talk with your doctor about the best treatment plan for you. Treatment options include:
is often used initially, with improvement in symptoms in up to half of patients who are treated.
- According to the Food and Drug Administration (FDA), patients of Asian ancestry who have a certain gene, called HLA-B*1502, and take carbamazepine are at risk for dangerous or even fatal skin reactions. If you are of Asian descent, the FDA recommends that you get tested for this gene before taking carbamazepine. If you have been taking this medicine for a few months with no skin reactions, then you are at low risk of developing these reactions. Talk to your doctor before stopping this medicine.
—These may also be beneficial for treating hemifacial spasm in some patients.
(ie, Botox) 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.
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.
There is no known way to prevent hemifacial spasm.
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Last reviewed March 2013 by Rimas Lukas, 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.
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