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You might be curious about the causes of hemifacial spasms if you have been diagnosed with the condition. Once you know what causes this condition and its symptoms, you can start considering your treatment options.

What Are Hemifacial Spasms?

Hemifacial spasms, also known as tic convulsive, occur when the muscles suddenly twitch on one side of the face (typically the left). These spasms are brought on by irritation or damage to the facial nerve, also called the seventh cranial nerve. Facial spasms happen when muscles contract involuntarily due to this nerve irritation.

Hemifacial spasms can occur in either men or women; however, women are over 40 times more likely than men to acquire the condition. Hemifacial spasms are more common in middle-aged and older women. Additionally, the illness is somewhat more prevalent in Asian populations.

Hemifacial spasms are typically not painful and are not considered a health risk. However, in severe cases, the eyes may remain shut so long that it becomes unsafe to partake in daily activities, such as driving a car.

What Causes Hemifacial Spasms?

An MRI, a CT scan and neurological examinations can be carried out to identify the condition’s cause. Several factors can cause hemifacial spasms, including:

  1. Vascular compression of the nerve: Hemifacial spasm is usually caused by a small artery compressing the facial nerve. Your heartbeat presses on the nerve, causing it to misfire and spasm.
  2. Multiple sclerosis: Multiple sclerosis is an autoimmune disorder in which the body mistakes nerve coverings for foreign substances. The immune system eats the nerve sheath. This exposes the nerve, causing hemifacial spasms.
  3. Benign tumor or lesion compression: A tumor or lesion on the nerve sheath can compress the facial nerve. Sometimes, lesions can also arise. Both can press against the nerve, forcing it to malfunction and emit erroneous impulses, causing spasms.
  4. Vascular malformation: Sometimes arteries or veins do not develop properly, causing them to travel in odd directions throughout the body. In hemifacial spasms, this malformation may compress or constrict the facial nerve.
  5. Nerve injury: Nerve injuries can cause hemifacial spasms. Most facial nerve injuries are caused by head or neck trauma that pinches or stretches the nerve. Accidents and falls are the most common causes of back, neck and head nerve damage.

Hemifacial Spasm Treatment

A hemifacial spasm cannot be cured, although it can be treated to reduce the symptoms. Botulinum toxin type A (Botox®) injections are often used to treat hemifacial spasms. Botox weakens the affected muscles and lessens spasms for three to six months. Additionally, you might be given prescriptions for anticonvulsant medications like phenytoin or carbamazepine.

If Botox and medications are ineffective, surgical treatment may be required to alleviate any pressure on the facial nerve produced by a tumor or a blood vessel. Microvascular decompression surgery is a frequent procedure for treating hemifacial spasms. However, a risk versus benefit analysis should be conducted, given the potential dangers associated with surgical treatment.

If you are experiencing any facial twitching, please contact us at New York Facial Paralysis to make an appointment with a specialist or visit our New York City offices today. We will be delighted to talk with you about effective treatment options.

Posted on behalf of New York Facial Paralysis

Grand Park Building, 110 East 40 Street, Suite 501
New York, NY 10016

Phone: (212) 434-4050

FAX: (212) 434-4059


Monday - Friday: 8:30 AM – 5:00 PM



New York Facial Paralysis

At Manhattan Eye, Ear, and Throat Hospital

Grand Park Building, 110 East 40 Street, Suite 501
New York, NY 10016

(212) 434-4050 (212) 371-3223 (FACE)

Opening Times: Monday - Friday: 8:30 AM – 5:00 PM

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