Hemifacial Spasms

What are hemifacial spasms?

Hemifacial spasms are twitching or spasms on one side of your face. The spasms are usually painless. They are chronic, which means they do not go away without treatment. The muscles may twitch even during sleep. Often the muscles around the eyes are affected along with the muscles of the cheek and corner of the mouth.

How do they occur?

Hemifacial spasms usually happen when a blood vessel puts pressure on the facial nerve. This pressure causes the nerve to work abnormally. Rarely the pressure is caused by a tumor or other growth. Or it may follow Bell's palsy, in which part of the face suddenly becomes paralyzed.

What are the symptoms?

The symptoms are:

• spasms of muscles in one side of the face only
• excessive tearing
• spasms of the corner of the mouth, which may cause problems eating, swallowing, and speaking.

Usually the spasms start around the eyes and go down the face. Less often they start around the mouth and go up to the forehead.

How are they diagnosed?

Your doctor will ask about your symptoms and examine you. Your doctor may want you to have an MRI scan to check for tumors or blood vessel problems.

How are they treated?

Medicines may help stop the muscle spasms. But often what works for one person may not work for another. Also, the benefits may not last very long. You will need to work closely with your doctor to find out what medicine and dosage work for you. Sometimes researchers find new medicines that may help. Or they find that medicines used for other diseases provide relief for some people. Ask your doctor about the latest research on medicines to treat hemifacial spasms.

Very small amounts of a medicine called botulinum toxin A (Botox) can be injected into the muscles near the facial nerve. These injections stop the muscle spasms for several months for some people. The injections usually need to be repeated.

Sometimes surgery is necessary to stop the spasms. The surgeon moves the blood vessel off of the facial nerve. This stops or reduces the spasms in many cases. The surgery is most successful for people who have had symptoms for a short time.

How can they be prevented?

There is nothing you can do to prevent hemifacial spasms.