Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions to occur in the muscles on one side of the face.
Causes
Hemifacial spasm is believed to be due in part to compression of the facial nerve where it meets the brainstem. The compression can be cause by:
Risk Factors
The following factor increases your chance of developing hemifacial spasm:
Symptoms
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Intermittent twitching of the eyelid muscle
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Forced closure of the eye
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Spasms of the muscles of the lower face
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Mouth pulled to one side
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Continuous spasms involving all the muscles on one side of the face
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:
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Electromyography (EMG)
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Magnetic resonance imaging (MRI) – a test that uses magnetic waves to make pictures of structures inside the head
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Computed tomography (CT) scan – a type of x-ray that uses a computer to make pictures of structures inside the head
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Angiography
Treatment
Hemifacial spasm is usually a chronic condition, and remission of symptoms, although possible, has only been noted to occur in less than 10% of patients.
Talk with your doctor about the best treatment plan for you. Treatment options include:
Medication
Treatment with carbamazepine is often used initially, with improvement in symptoms in up to half of patients who are treated.
Botulinum Toxin Injections
Injecting botulinum toxin (ie, Botox) into the affected muscles can stop eyelid spasm for several months. However, these injections must be repeated, usually several times a year.
Surgery
Microvascular decompression surgery, which repositions the blood vessel away from the nerve, is successful in cases of hemifacial spasm in which the cause is suspected to be a blood vessel compressing the facial nerve.
Prevention
There is no known way to prevent hemifacial spasm.
RESOURCES:
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
National Organization for Rare Disorders
http://www.rarediseases.org/
CANADIAN RESOURCES:
Canadian Movement Disorder Group
http://www.cmdg.org
Hemifacial Spasm Association
http://www.hfs-assn.org/
References:
Alexander GE, Moses H. Carbamazepine for hemifacial spasm. Neurology. 1982;32:286-287.
Defazio G, Martino D, Aniello MS, et al. Influence of age on the association between primary hemifacial spasm and arterial hypertension. J Neurol Neurosurg Psychiatry. 2003;74(7):979-981.
Digre K, Corbett JJ. Hemifacial spasm: differential diagnosis, mechanism, and treatment. Adv Neurol. 1988;49:151-176.
Ehni G, Woltman HW. Hemifacial spasm. Arch Neurol Psychiatry. 1945;53:205-211.
Hemifacial spasm. Chicago Institute of Neurosurgery and Neuroresearch website. Available at: http://www.cinn.org/other/hemifacial-spasm.html. Accessed February 28, 2007.
Hemifacial spasm information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/hemifacial_spasm/hemifacial_spasm.htm. Accessed February 28, 2007.
