Hemifacial spasm

Introduction

​Hemifacial spasm is a nerve disorder that causes uncontrolled twitching of muscles in one side of the face. It affects men and women but is more common in women aged over 40 years.

Signs and Symptoms​

Hemifacial spasm usually affects one side of the face. It usually starts with twitching of one eye and it can progress to other muscles on the same side of the face, such as causing twitching or spasms in the cheek and side of the mouth. The twitching and spasms are painless and the person has no control over them.

Causes

​Hemifacial spasm is often caused by a ​blood vessel touching a nerve in the face. Other causes can include injury to a nerve in the face or a tumour. However, sometimes no cause can be identified. Stress, tiredness and fatigue can make the twitching and spasms worse.

Treatment

There are many modalities of treatment to be considered in hemifacial spasm to help control the spasms and twitching and even provide cure in some instances.

• Botulinum injections (Botox) to temporarily paralyse the affected muscles to prevent twitching. The effects usually last several months and repeat injections are required once the benefits wear off.
• Medication such as anticonvulsant drugs to block the signs that cause the spasms.
• Decompression surgery to relieve pressure on the nerve caused by a blood vessel. This modality offers a chance of "cure" of hemifacial spasm.
​