Hemifacial spasm

Symptoms of hemifacial spasm happen on one side of the face usually the left. These involuntary spasms can occur around the eye, cheek and mouth, and can get worse under stress. General symptoms include:

• twitching of the eyelid muscle this may come or go
• muscle spasms which force an eye shut
• muscle spasms in the lower face
• mouth to one side
• muscle spams across the length of the face
• pain behind the ear

Your consultant will discuss your symptoms with you and help to make a diagnosis. After ruling out other conditions such as multiple sclerosis, they may order some imaging tests. An MRI scan creates clear images of your head and may display (though not always) the blood vessel responsible for the facial spasms. A contrast dye may be used to display the vein more clearly on the MRI scan.

Your consultant will discuss your treatment options and help to determine the best approach for you.

• Muscle-relaxant injections are an effective way to treat hemifacial spasms. They temporarily paralyse the muscles responsible for the spams. You will need regular injections.
• Microvascular decompression surgery is another option. Here, a neurosurgeon opens the skull, locates the facial nerve and puts artificial material (Teflon wool) between the nerve and blood vessel. This relieves pressure on the nerve and stops the spasm.