A hemifacial spasm is a neuromuscular disorder that affects the muscles that are activated by the facial nerve. It is characterized by an involuntary twitch on one side (hemi) of the face.

It usually starts with intermittent tics or spasms of the eye muscle, which can be so severe that the eye becomes forced shut. The spasms may then spread to the muscles of the lower face, which could result in the mouth being pulled to one side. It is possible for the spasms to eventually spread to all of the muscles on one side of the face and neck.

Hemifacial spasms are very rare. Only about 8 of every 100,000 men and 15 of every 100,000 women get it. Spasms that occur on the left side of the face are slightly more common than spasms that occur on the right side of the face.

Most people who get hemifacial spasms are over the age of 40. Some underlying neurological diseases such as multiple sclerosis can sometimes cause younger people to get it.

It is generally more common in women than in men.

Causes for Hemifacial Spasms

Hemifacial spasms are usually caused by a damaged facial nerve, which carries signals from the brain to the facial muscles. The damage can occur as a result of an injury or a tumor or it may have no discernable cause at all. Hemifacial spasms are often caused by a dislocated blood vessel that presses on the facial nerve.

Treatment Options

Treatment usually involves injecting botulinum toxin (Botox) into the affected muscles. Most patients respond favorably to the Botox injections, but in severe cases, surgery may be necessary. Surgery is considered when it is believed that the cause of the spasms is a blood vessel that is pressing on the facial nerve. A neurosurgeon will attempt to reposition the blood vessel away from the nerve.

Why Come to the University of Maryland for Hemifacial Spasm Treatment?

University of Maryland neurologists have a lot of experience in treating this condition and in botulinum toxin injections, which is the primary treatment option. Should surgery be necessary, one of our experienced neurosurgeons will do the procedure in consultation with our neurologists and other members of our multidisciplinary team.