Hemifacial Spasm

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What is hemifacial spasm?

Hemifacial spasm is a neuromuscular disorder that involves frequent contractions or spasms of the muscles on one side of the face. The spasms are involuntary, meaning they happen on their own without trying. The disorder occurs in both men and women, yet it is more common in middle-aged or older women. It is also much more common in the Asian population.

The first symptom is usually twitching of the eyelid muscle that comes and goes. This can then lead to forced closure of the eye. The spasm may then gradually spread to involve the muscles of the lower face, pulling the mouth to one side. Eventually the spasms involve all of the muscles on one side of the face almost nonstop. Rarely, doctors see individuals with spasm on both sides of the face.

The condition may be caused by:

  • A facial nerve injury
  • A tumor
  • No apparent cause

Most often hemifacial spasm is caused by a blood vessel pressing on the facial nerve at the place where it exits the brainstem.

Injection of botulinum toxin into the affected areas is the most effective therapy. It is also the only one used in most cases. Microvascular decompression surgery relieves pressure on the facial nerve and can provide relief in many cases. This surgery can have significant side-effects, so risks and benefits have to be weighed. Drug therapy generally does not work.

The outlook for people with hemifacial spasm depends on the treatment and how they respond. Some people will be nearly free of symptoms with injection therapy. Some may require surgery. In most cases, people are able to find balance between symptoms they can tolerate and risks of treatment.

Learn About Clinical Trials
Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for people with hemifacial spasm?

Consider participating in a clinical trial so clinicians and scientists can learn more about hemifacial spasm and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with hemifacial spasm at Clinicaltrials.gov.

Where can I find more information about hemifacial spasm?                     

The following organizations and resources can help individuals, families, friends, and caregivers of people living with hemifacial spasm:

Benign Essential Blepharospasm Research Foundation

National Organization for Rare Disorders (NORD)
203-744-0100 or 800-999-6673; 844-259-7178 Spanish

Order publications from the NINDS Catalog
The NINDS Publication Catalog offers printed materials on neurological disorders for patients, health professionals, and the general public. All materials are free of charge, and a downloadable PDF version is also available for most publications.