Hemi-facial Spasm

Hemi-facial spasm is a neuromuscular disorder characterized by involuntary twitching of one side of the face. The spasms are not painful but the disorder can cause anxiety and self-consciousness, discomfort, and vision problems due to forced eye closure.

Symptoms

A twitching of the eyelid, extending down one side of the face through the cheeks and mouth.

About this Condition

Hemi-facial spasm is a neuromuscular disorder characterized by involuntary twitching of one side of the face. The spasms are not painful but the disorder can cause anxiety and self-consciousness, discomfort, and vision problems due to forced eye closure. The spasms generally start around the eye and present as a twitching of the eyelid. Over time, the spasms become more frequent and begin to extend down the face through the cheeks and mouth. Spasms come without warning and are often brought on or worsened by stress, fatigue or speaking.

Hemi-facial spasms occurs when a blood vessel contacts and compresses the facial nerve root. The vessel irritates the nerve root resulting in hyperactivity of the facial nerve, which in turn causes the uncontrollable twitching or spasms. This neurovascular compression can be a result of facial injury, a tumor, or it may have no apparent cause.

This content is for your general education only. See your doctor for a professional diagnosis and to discuss an appropriate treatment plan.

Conservative Treatments

Medications for Hemi-facial Spasm

Anti-seizure medications may decrease the frequency and intensity of the spasms.

Finding the right medication and dosage can be complex. Your doctor likely will first prescribe a single drug at a relatively low dosage and may increase the dosage gradually until your spasms are well controlled.

All anti-seizure medications have some side effects. Mild side effects include:

Fatigue
Dizziness
Weight gain
Loss of bone density
Skin rashes
Loss of coordination
Speech problems

More severe but rare side effects include:

Depression
Suicidal thoughts and behaviors
Severe rash
Inflammation of certain organs, such as your pancreas or liver

Surgery

Microvascular Decompression

Microvascular decompression involves separating the nerve root and blood vessels with a small Teflon pattie so they are no longer in contact.

During the surgery, your doctor makes an incision behind the ear on the side of your pain to access your facial or trigeminal nerve. Any artery in contact with the nerve root is directed away from the nerve, and the surgeon places a pad between the nerve and the artery.

Decompression can successfully eliminate or reduce symptoms most of the time, but they can recur in some people. While the surgery has a high success rate, it also carries risks. There are small chances of decreased hearing, facial weakness, facial numbness, double vision and even a stroke or death.