Hemifacial Spasm

What is a hemifacial spasm?

Hemifacial spasms are twitching or squeezing of muscles on one side of your face. The spasms are usually painless and you can’t control them. The muscles may twitch even during sleep. They do not go away without treatment.

What is the cause?

Hemifacial spasms can happen when something puts pressure on the facial nerve near your brain. This pressure changes the way the nerve works. The pressure may be caused by:

  • Hardened or blocked blood vessels near the brain
  • An injury
  • A tumor or other growth

You are also more likely to have hemifacial spasms if you had Bell’s palsy at some time in your life. Bell’s palsy is a weakness or paralysis of a facial nerve.

What are the symptoms?

Symptoms may include:

  • Twitching in your eyelid muscle that can cause your eye to close
  • Spasms of muscles on one side of the face only
  • Watery eyes
  • Spasms of the corner of the mouth, which may make it hard to eat, swallow, or talk

Usually the spasms start around your eyes and spread to other face muscles. Less often they start around the mouth and go up to the forehead.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and do exams and tests such as:

  • CT scan, which uses X-rays and a computer to show detailed pictures of your brain and facial nerves
  • MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your brain and blood vessels

How is it treated?

Hemifacial spasms are usually treated with medicine or with surgery.

Very small amounts of botulinum toxin A can be injected into the muscles near the facial nerve. This may weaken or stop the muscle spasms for several months. The shots need to be repeated to keep spasms under control.

Medicines taken by mouth may also help to control the muscle spasms for a short time, but they may cause other side effects. Talk with your healthcare provider about this.

Sometimes surgery is needed to stop the spasms. Surgery is most successful for people who have had symptoms for a short time.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent hemifacial spasms?

There is nothing you can do to prevent hemifacial spasms.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-10-27
Last reviewed: 2014-10-27
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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