Hemifacial Spasm (Half-Face Spasm)

Involuntary, repetitive contractions of facial muscles on one side of the face; usually caused by a blood vessel compressing the facial nerve.

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Movement Disorders

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1Overview

Quick and clear information for patients

What is this Condition?

Hemifacial spasm is involuntary, repetitive contraction of muscles on only one side of the face. It usually begins with twitching around the eye, and may spread to the cheek and mouth area over time. Symptoms typically occur beyond the person's control and diminish or disappear during sleep. In the vast majority of patients, the cause is compression of the facial nerve root as it exits the brainstem by a small artery; this compression gradually disrupts the nerve's conduction. Although not a dangerous disease, frequent eye closure and visible contractions may affect vision, social life, and work. Effective treatment options are available.

Symptoms

Unilateral, involuntary facial contractions (initially eyelid twitching)

Spread of contractions over time to cheek, mouth area, and neck

Frequent eye closure causing interruption of vision

Worsening with stress, fatigue, and sleep deprivation

Reduction or disappearance of symptoms during sleep

Social anxiety, embarrassment, and resulting mood disturbance

Diagnosis Methods

Diagnosis is usually made from history and examination; unilateral contractions beginning at the eyelid and spreading to the lower face that disappear during sleep are typical. It is important to perform brain MRI with special sequences to exclude an underlying cause (tumor, vascular anomaly, etc.). When needed, investigations such as MR/CT angiography showing vascular anatomy and electromyography (EMG) may be added.

Treatment Methods

First-line treatment consists of botulinum toxin (Botox) injections applied to the affected muscles; the effect lasts several months and is repeated at regular intervals. In patients who wish to permanently eliminate vascular compression and are suitable for surgery, a procedure called microvascular decompression can be performed; in this surgery, the blood vessel compressing the nerve is separated from the nerve and a small protective cushion is placed between them. Oral medications have limited effectiveness.

Botulinum toxin (Botox) injections (typically every 3-4 months)

Microvascular decompression surgery (relief of vascular compression)

Oral medications (limited effectiveness)

Supportive measures such as stress management and regular sleep

Treatment Path

Related Treatments

The procedures and interventions most commonly explored with this condition.

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DBS implantasyonu, iki taraflı

DBS implantasyonu, iki taraflı procedure

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DBS implantasyonu, mikroelektrod kayıt eşliğinde

DBS implantasyonu, mikroelektrod kayıt eşliğinde procedure

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Baklofen pompası implantasyonu

Baklofen pompası implantasyonu procedure

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References

Greenberg MS. Handbook of Neurosurgery. 10th ed. Thieme; 2023:1738-1745.
Simpson L, Raslan AM. Microvascular decompression. In: Functional Neurosurgery and Neuromodulation. Elsevier; 2019.
Winn HR, ed. Youmans and Winn Neurological Surgery. 6th ed. Elsevier; 2011.

This content is for informational purposes and based on academic sources; consult your physician for diagnosis and treatment.

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Functional Neurosurgery - Other Conditions

Parkinson's Disease Epilepsy Tremor Dystonia Trigeminal Neuralgia Spasticity (Cerebral Palsy - Intrathecal Baclofen Pump)Hemifacial Spasm (Half-Face Spasm)Glossopharyngeal Neuralgia (Pharyngeal-Lingual Nerve Pain)

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Hemifacial Spasm (Half-Face Spasm)

Movement Disorders

1Overview

What is this Condition?

Symptoms

Diagnosis Methods

Treatment Methods

Related Treatments

DBS implantasyonu, tek taraflı

DBS implantasyonu, iki taraflı

DBS implantasyonu, mikroelektrod kayıt eşliğinde

Baklofen pompası implantasyonu

References

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