Hemifacial Spasm

What is Hemifacial Spasm?

Hemifacial spasm means the muscles on one side of the face twitch involuntarily. This condition may be caused by a blood vessel touching a facial nerve, a facial nerve injury or a tumor, or the cause may be unknown. Hemifacial spasm usually affects one side of the face.

Baptist Health is known for advanced, superior care in diagnosing and treating hemifacial spasm. Our 24/7 inpatient neurology and neurosurgery services, as well as our outpatient and Home Health physical, occupational, cognitive and speech therapy services are available to help treat people with hemifacial spasm. In addition, we have the region’s only advanced 3Tesla MRI, MRI spectroscopy and functional MRI technology to accurately diagnose all manner of neurologic disease, including hemifacial spasm.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Hemifacial spasm symptoms include:

  • Involuntary muscle twitching on one side of the face
  • Twitching that begins around the eye and spreads to other facial muscles
  • Twitching that begins as intermittent but may become nearly continuous

While hemifacial spasms can cause twitching for an extended period of time, the spasms are typically painless. Hemifacial spasm pains are not common.


To determine if someone has hemifacial spasm, we conduct a physical examination. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Electromyography (EMG):  This test measures the electrical activity of a muscle in response to stimulation, as well as the nature and speed of the conduction of electrical impulses along a nerve.  It can confirm the presence of nerve damage and assess its severity.

Magnetic Resonance Imaging (MRI): This test uses a powerful magnet and radio waves to detect tumors, structural abnormalities, evidence of multiple sclerosis, an abnormal blood vessel pressing on a facial nerve or other abnormalities.


Hemifacial spasm causes vary from patient to patient. In some patients, there may be no identifiable causes. Common hemifacial spasm causes include:

  • Injury to the facial nerves
  • Tumor or blood vessel compressing a facial nerve
  • Damage from multiple sclerosis (MS)

Risk Factors

Risk factors that may contribute to hemifacial spasm include:

Age: Hemifacial spasm is most common in middle-aged to elderly adults.
Ethnicity: People of Asian descent seem to be more frequently affected.
Gender: Hemifacial spasm is more common in women.


Prognosis for hemifacial spasm depends on a person’s response to treatment. Some people become symptom-free with injection therapy. Some require surgery. Residual symptoms may remain after treatment.

Treatment and Recovery

Hemifacial spasm treatment may include:

Botox Injections

Botulinum toxin injection directly into the affected muscles can halt muscular spasms for several months, but the effect is often temporary and repeated treatments are usually necessary.


In some cases, hemifacial spasm medication can be useful. While there is no traditional hemifacial spasm medication, symptoms like twitching can be controlled by anti-seizure medications or mild tranquilizers.

Hemifacial Spasm Surgery

In a procedure called microvascular decompression, a surgeon moves a blood vessel away from the affected nerve and places a padded material between the nerve and vessel. Most patients experience immediate relief after surgery, but some experience fewer spasms over time. Hemifacial spasm surgery recovery is relatively quick with patients being discharged 1 or 2 da


Rarely, microvascular decompression treatment for hemifacial spasm can cause complications, like slight hearing loss on the affected side.

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