At a glance
What it is
A neurological condition in which muscles on one side of the face involuntarily twitch or contract. More common in middle-aged to elderly women.
Common cause
Pressure on the facial nerve — most often from an enlarged blood vessel near the brainstem, less commonly from a tumour.
Approach
Botox injections are the primary treatment. rTMS, physiotherapy, and pulsed radiofrequency are added as needed. Surgery (microvascular decompression) is reserved for refractory cases.
What hemifacial spasm is
Hemifacial spasm is a neurological condition in which the muscles on one side of the face begin to involuntarily twitch or contract. Intensity varies widely among patients. It occurs in both men and women but most commonly affects middle-aged to elderly women.
The two facial nerves emerge directly from the brainstem and enter the face just in front of the ear — one nerve on each side — controlling the muscles of facial expression. Hemifacial spasm typically arises when one of these nerves is irritated by pressure or injury.
**Causes:** The most common cause is an enlarged blood vessel pressing on the nerve at its exit from the brainstem. Less frequently, a tumour may cause the pressure. In some cases, no identifiable cause is found.
**Symptoms:** Symptoms usually begin with mild, intermittent twitching of one eyelid and may progress to involve the lower face. In more severe cases, intense and continuous muscle spasms spread across the entire affected side.
**Prognosis:** Outcomes vary with severity. Some patients are managed successfully with minimal intervention; others require multiple treatment modalities. Ongoing treatment to suppress muscle spasms may be needed in persistent cases.
Treatment options at Alimran Medical Center
First-line treatment
Physiotherapy
- Electrical stimulation
- Short and long wave therapy
- Laser therapy
- Ultrasound therapy
- Therapeutic exercises
Advanced therapies
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about hemifacial spasm and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.