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Hemifacial Spasm

Definition

Hemifacial spasm (HS) causes muscles to contract on one side of the face. They happen without your control.

Causes

HS doesn't always have a cause. It may be due to:
  • A blood vessel pressing on the facial nerve
  • Tumor
  • Facial nerve injury
  • Bony or other abnormalities that press the nerve
Muscles of the Face
Muscles of the Face
Copyright © Nucleus Medical Media, Inc.

Risk Factors

HS is more common in older women.

Symptoms

You may have:
  • Twitching of the eyelid muscle
  • Forced closure of the eye
  • Lower face spasms
  • Mouth pulled to one side
  • Spasms of all the muscles on one side of the face

Diagnosis

Your doctor will ask about your symptoms and health history. You may have:
  • A physical exam
  • Electromyography (EMG)—records eletricity generated in muscle while at work and at rest
  • Angiography —uses contrast material to see blood vessels
Pictures of your body may be taken This can be done with:

Treatment

Talk with your doctor about the best plan for you.

Medication

Your doctor may have you take antiseizure medicines. They may help to ease symptoms.

Injections

Botulinum toxin may be injected into the muscles. It can stop eyelid spasm for many months. This must be repeated, usually many times a year. This is the main way to treat HS.

Surgery

You may have surgery to reposition the blood vessel away from the nerve. This is helps people with HS caused by a blood vessel pressing on the facial nerve.

Prevention

HS can't be prevented.

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
Health Canada
https://www.canada.ca

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: https://www.ninds.nih.gov/disorders/all-disorders/hemifacial-spasm-information-page. Accessed June 20, 2018.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 05/2018
  • Update Date: 06/19/2018
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