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Definition  

Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions to occur in the muscles on one side of the face.

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Muscles of the Face  
Muscles of the Face

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Causes  

Hemifacial spasm doesn't always have a specific cause. It may occur as a result of:

  • A blood vessel pressing on the facial nerve
  • Tumor
  • Facial nerve injury
  • Bony or other abnormalities that compress the nerve
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Risk Factors  

Hemifacial spasm is more common in middle-aged and elderly women. It is also more common in Asians.

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Symptoms  

  • Intermittent twitching of the eyelid muscle
  • Forced closure of the eye
  • Spasms of the muscles of the lower face
  • Mouth pulled to one side
  • Continuous spasms involving all the muscles on one side of the face
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Diagnosis  

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

  • Electromyography (EMG)—records electrical activity generated in muscle while contracting and relaxing
  • Angiography—uses contrast material to see blood vessels

Images of internal body structures may be taken with an MRI scan or CT scan.

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Treatment  

Talk with your doctor about the best treatment plan for you.

Medication  

Your doctor may recommend antiseizure medications to help relieve symptoms.

Botulinum Toxin Injections  

Injecting botulinum toxin into the affected muscles can stop eyelid spasm for several months. These injections must be repeated, usually several times a year. Botulinum toxin injections are the treatment of choice.

Surgery  

Microvascular decompression surgery repositions the blood vessel away from the nerve. This is successful in cases of hemifacial spasm where the cause is suspected to be a blood vessel compressing the facial nerve.

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Prevention  

There are no current guidelines to prevent hemifacial spasm.