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Hemifacial Spasm

Find Effective Treatment for Hemifacial Spasms at Raleigh Neurosurgical Clinic

What Is Hemifacial Spasm?

Hemifacial spasm is a nervous system disorder in which one side of the face twitches involuntarily. It’s usually caused by blood vessel compression of the facial nerve where the nerve exits the brainstem.

The condition can affect both men and women, but it most often occurs in middle-aged or elderly women.

Because there are many types of facial movement disorders, it can be challenging to diagnose hemifacial spasm. At Raleigh Neurosurgical Clinic, we take a careful and detailed medical history in addition to obtaining magnetic resonance imaging (MRI).

What Causes Hemifacial Spasm?

Hemifacial spasm is most commonly caused by compression of the facial nerve where the nerve exits the brainstem by one or more tortuous blood vessels such as the anterior inferior cerebellar artery, posterior inferior cerebellar artery, or the vertebral artery. When this happens, the nerve sends out signals that cause the muscles to twitch.

Other, less common causes of hemifacial spasm include:

  • Benign (noncancerous) tumor or lesion pressing on the nerve
  • Injury to the nerve
  • Vascular malformation
  • Bell’s palsy
  • Multiple sclerosis

Sometimes the disorder has no clear cause; this is called idiopathic hemifacial spasm.

What are the Symptoms of Hemifacial Spasm?

Muscle contractions usually begin in the eyelid and are mild. Over time, spasms can spread to other parts of your face, such as the cheek, lips, chin, and jaw. Eventually, they may occur continuously.

Symptoms may be worse if you’re feeling tired, anxious, or stressed. Although the spasms aren’t painful, they may cause distress or embarrassment. They can also interfere with vision and regular facial expressions.

How Is Hemifacial Spasm Diagnosed?

If you have been experiencing ongoing symptoms and are concerned about hemifacial spasm, please make an appointment at Raleigh Neurosurgical Clinic.

Our doctors begin their thorough evaluation by taking a full medical history and conducting a neurological exam. We’ll also obtain an MRI with and without contrast, which produces detailed images of your head using magnets and radio waves and helps us see an abnormal blood vessel that may be putting pressure on the facial nerve. This can help us determine the best course of treatment.

How Is Hemifacial Spasm Treated?

We may recommend:

  • Botox injections: Using a very fine needle, a small amount of botulinum toxin is injected around the affected facial muscles. This weakens the muscles and stops the contractions for three to six months.
  • Microvascular decompression or neurovascular transposition: We’ll make a small opening in the skull to expose the facial nerve where it’s affected, and we’ll move or transpose the offending vessel(s) off the facial nerve with a teflon sling or bridge to alleviate the compression.

Oral medications are rarely effective for hemifacial spasm.

Guiding You Through Your Healthcare Journey

Getting the treatment you need for hemifacial spasm can be complicated. Our nurse navigator program makes it easier. Your nurse navigator can help you with various aspects of your care, including scheduling appointments, getting connected with helpful resources, interpreting unclear medical language, and offering emotional support.

Learn more about the nurse navigator program at Raleigh Neurosurgical Clinic.

Make an Appointment

At Raleigh Neurosurgical Clinic, world renowned neurosurgeon Dr. Takanori Fukushima, as well as our skilled neurosurgeons, have extensive experience treating hemifacial spasm. To meet with one of our hemifacial spasm specialists:
Contact a nurse navigator