Symptoms and Causes of Hemifacial Spasm

Hemifacial spasm, or tic convulsive, is the involuntary twitching or contraction of muscles on one side of the face. The facial muscles are controlled by the 7th cranial nerve, which control movement of the mouth, eyes and lips. In the majority of cases, hemifacial spasm begins at the eye, progressing downward over time. Alternately, it can start at the chin, and work its way upwards.

Patients may experience chronic facial tightness, and the emotional effects of social stigma can be significant. In severe cases, contractions can interfere with vision. Spasms, or tics, can become more severe and frequent over time as the condition worsens, possibly leading to facial paralysis. Left untreated, hemifacial spams can result in all the muscles on one side of the face being affected.

Hemifacial spasm is relatively rare, affecting approximately 8 in 100,000 people in the U.S.

Causes of hemifacial spasm include injury to the facial nerve, vascular compression (tumors or blood vessel that compress the facial nerve). Most commonly, hemifacial spasm is caused by compression of the facial nerve by the anterior inferior cerebellar artery.

Hemifacial Spasm Treatment

There is no cure for hemifacial spasm, though available treatments can alleviate the symptoms. Treatment options available include medical and surgical procedures. A medical treatment involves the use of large doses of botulinum toxin injections to weaken the muscles affected by the spasm. Anticonvulsant drugs such as carbamazepine or phenytoin may be prescribed. Botox injections can be used to paralyze affected muscles, and reduce spasm.

When medication or injection do not control the spasm, surgical treatment becomes necessary. Microvascular decompression is a surgical procedure that can reduce pressure on the facial nerve. As there are potential risks involved with surgical treatment, an assessment of risks versus benefits should be made.

Contact our office today to schedule a consultation with one of our specialists about your condition.