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Compassionate Care for Hemifacial Spasm

Expert Hemifacial Spasm Care

If you’re living with hemifacial spasms, you may feel embarrassed or self-conscious when your facial muscles move involuntarily, and you’re likely frustrated that you can’t control it when a spasm happens. But don’t let a treatable condition diminish your quality of life. 

At the AdventHealth Neuroscience Institute, we offer minimally invasive treatments for hemifacial spasm so you can regain control and confidence. And although we treat more neuroscience patients — and perform more neurosurgical procedures — than any other hospital in the nation, we still see each patient as a person with unique needs. 

About Hemifacial Spasm

Hemifacial spasm, sometimes called a facial twitch, is an involuntary contraction of the facial muscles. As the prefix “hemi-” implies, spasms will almost always affect half or one side of the face. 

Although the condition isn’t usually painful, hemifacial spasms can cause frustration and anxiety for people who live with the neurological disorder. The most common cause of hemifacial spasm is a compressed facial nerve. Usually, the nerve is compressed by an abnormal blood vessel or artery. 

Hemifacial spasm symptoms can be slightly different for everyone. Twitches around the eye, cheek and corner of the mouth on one side of the face are the most common signs. 

Severe spasms can pull the eyelid entirely closed and cause the eye to water, which can interfere with vision. Some people also experience spasms that cause ear pain and hearing loss. Unlike other facial nerve disorders like trigeminal neuralgia , hemifacial spasm symptoms can continue during sleep. 

Facial nerve compression is the most common cause of hemifacial spasm. Vascular abnormalities are usually the source of the compression. Abnormal veins or arteries touch a facial nerve and trigger electrical impulses that cause involuntary muscle movements. 

Vascular disorders that can cause facial nerve compression include:

  • Aneurysm 
  • Arteriovenous malformation (AVM) 
  • Arteriovenous fistula (AVF) 

In some cases, brain tumors or lesions can also press on facial nerves. Bell’s palsy, a condition that causes paralysis and drooping on one side of the face from facial nerve trauma, can contribute to hemifacial spasm.

See a doctor right away if you experience any signs of twitching, drooping or other involuntary movements on one side of your face. While a hemifacial spasm is not considered a medical emergency, it’s extremely important to rule out the possibility of a more serious condition like a transient ischemic attack (TIA), sometimes called a mini-stroke.

A doctor should also conduct diagnostic tests to determine the underlying cause of your facial nerve compression. Magnetic resonance imaging, or MRI, can rule out the possibility of a stroke or tumor. An angiogram, which is a type of X-ray that uses dye to create a map of your body’s blood vessels, can reveal vascular abnormalities in the brain. 

A study of nerve conduction in the face can also be useful to confirm a hemifacial spasm diagnosis. An electromyogram (EMG) and a nerve conduction velocity (NCV) study can measure muscle and nerve activity. 

Medications like anticonvulsants can help reduce the severity of facial twitches from hemifacial spasm. Muscle-relaxing injections such as Botox® may also be recommended as a nonsurgical approach to hemifacial spasm treatment. 

Hemifacial Spasm Surgery: Microvascular Decompression

Microvascular decompression is a minimally invasive procedure that separates nerves from the veins or arteries that may be exerting pressure on them. During this procedure, a surgeon makes a small incision behind your ear and removes a very tiny piece of the skull. After gaining access to the compressed nerve, a special type of sponge is placed between the nerve and blood vessel to eliminate pressure. 

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