Hemifacial spasm (HFS) is a chronic condition that typically does not go away without treatment. This nervous system disorder progresses gradually and may be visible in other muscles on the same side of the face. Gradually, spasms may eventually become permanent if left untreated.
What are symptoms of hemifacial spasm?
HFS is a rare disease that usually starts around the eye, causing it to twitch, blink, squeeze, or close. Sometimes, the eye on the affected side looks smaller or the eyelid looks droopy.
Over time, the condition affects the cheek area, causing the corner of the mouth to tighten and pull up. HFS may eventually affect the neck muscles and cause a clicking sound due to the involvement of the muscle in the middle ear.
Signs and symptoms may include:
- Major spasms on one side of the face that affect both the cheek and mouth
- Spasms that extend across the face, right up to the chin
- Mouth pulled to one side
- Changes in hearing
- Pain behind the ear
Symptoms often begin with mild intermittent twitching of one eyelid and may progress to the lower face. In more severe cases, it may progress to intense and continuous muscle spasms on one whole side of the face.
While the twitching is usually not painful, it can be embarrassing and interfere with normal expression and vision. Many individuals who suffer from hemifacial spasms find their condition socially isolating and can suffer from additional conditions, such as anxiety or depression.
What causes hemifacial spasms?
Hemifacial spasm is caused by the facial nerve becoming compressed, which leads to malfunctioning of the muscles responsible for facial expression. Compression causes the nerve to misfire, making the facial muscles contract involuntarily. Increased activity of the facial nerve is thought to be caused by irritation from a blood vessel adjacent to the nerve deep within the brain.
Risk factors and common causes may include:
- Age (more common in people over 40)
- Gender (more common in women)
- Ethnicity (more common in people of Asian ethnicities)
- Enlarged blood vessels
- Facial movements (smiling, talking, eating, blinking, etc.)
- Injury to the head or face
- Stress or anxiety
- Fatigue or lack of sleep
- Caffeine intake
In rare cases, HFS may be caused by:
What are treatment options for hemifacial spasms?
Although there is no guaranteed cure for HFS, available treatments include:
- Botox disrupts nerve messages to the muscles and causes muscles to relax, stopping the spasms.
- Multiple injections are usually given both above and below the eye and in the cheek.
- Muscle weakening begins after about 1-4 days, with effects lasting up to 4 months.
- Treatment works for about 70% -80% of people with hemifacial spasms.
- Anti-epileptic and benzodiazepine medications can be helpful when spasms are mild or infrequent, and they work by calming nerve impulses.
- Responses to these medications can vary, and it may take time to get the dosage right.
- These medications will need to be taken on a long-term basis.
- Vascular decompression can relieve compression caused by blood vessels on the facial nerve.
- While surgery can be curative, it can also cause serious side effects.
- For this reason, surgery is usually reserved for cases where the spasms are severe and disabling and when other treatments have failed.
The prognosis for each patient varies according to the severity of the condition. For some, symptoms are successfully managed with minimal intervention. For others, more than one form of treatment is needed before the condition is completely controlled.
Health Solutions From Our Sponsors
The National Institute of Neurological Disorders and Stroke. Hemifacial Spasm Information Page. https://www.ninds.nih.gov/Disorders/All-Disorders/Hemifacial-Spasm-Information-Page
Rosenstengel C, Matthes M, Baldauf J, Fleck S, Schroeder H. Hemifacial Spasm: Conservative and Surgical Treatment Options. Dtsch Arztebl Int. 2012;109(41):667-673. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487151/
Top Do Hemifacial Spasms Go Away Related Articles
BotoxBotox, the brand name of a toxin produced by the bacterium Clostridium botulinum, blocks signals from the nerves to the muscles. When Botox is injected into a muscle, it can no longer contract, causing the wrinkle to soften. Botox injections last from four to six months. Bruising is the most common side effect.
Can Facial Nerve Damage Be Repaired?A facial nerve originates in the brain and controls the muscles on one side of the face. There are two facial nerves, one for each side of the face. The facial nerve travels in and around the structures of the middle ear and along the jawbone to enter the parotid gland (one of the salivary glands) before the ear.
Your Face: A Window Into Your HealthWhat medical problems appear on your face? Look into the mirror and find out. Jaundice, glaucoma, skin cancer, and cracked lips are just some of the many health conditions with symptoms that show on your face. Learn to spot common face conditions and safeguard your family’s health.
How Can I Get My Eye To Stop Twitching?A blepharospasm (eye twitch) is a harmless, involuntary spasm of the muscle of the eyelids, which may resolve on its own. If the twitching isn't caused by an underlying condition, getting more rest and avoiding alcohol and caffeine may help stop it.
Muscle Cramps (Charley Horse) and Muscle SpasmsWhat are the differences between muscle spasms and cramps? Learn about the causes of muscle spasms and cramps (charley horse) in the calf, leg, and more.
Muscle SpasmsMuscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Non-Surgical Face LiftsSee before and after photos of the latest in nonsurgical cosmetic procedures for the face such as Botox, laser, and peel treatments. Learn ways to look younger without surgery.
What Is a Twitching Eye a Sign of?A blepharospasm (eye twitch) is a harmless tic of the eyelid muscle, which may resolve on its own. Conditions that may cause eye twitch include blepharitis, dry eyes, light sensitivity or conjunctivitis. Nerve disorders can also cause eye twitching.
What Is Botox Used For?Botox is a drug made from botulinum toxin, which is a neurotoxin that blocks the signaling processes between the nerves. This disturbs the muscle movements, especially muscle contraction that the concerned nerve controls. Extremely small doses of botulinum toxin are used in Botox injections, making Botox a safe drug.
What You Should Know Before Getting Facial FillersFacial fillers can help with wrinkles and other skin issues. Here’s what to expect when you inject.
When Should I Be Worried About Eye Twitching?An eye/eyelid twitch (myokymia), is an involuntary, repeated spasm of the eyelid muscle. It can happen in the upper or lower lids. Eye twitching is usually painless and harmless. It often resolves without treatment. Though less common, eye twitching is sometimes the first sign of a chronic movement disorder.
When Should I Worry About Muscle Twitching?What is muscle twitching, and how do you recognize it? Muscle twitching is a common issue that affects many people. Learn the signs of muscle twitching, what causes it, when to see a doctor, and how to treat it.
Why Are My Eyes Twitching?Eye twitching, or blepharospasm, is a condition in which you cannot keep your eyes open for a long time due to spasms. The main causes of eye twitch include fatigue, stress, smoking, caffeine, medication side effects, light sensitivity, lack of sleep, foreign particles in the eye, and corneal irritation.