Hemifacial Spasm – Diagnosis and Treatment
Diagnosis
Doctors usually start with a physical exam and review symptoms like involuntary facial twitching or eyelid spasm to spot hemifacial spasm.
They often check if the facial muscles or the 7th cranial nerve (facial nerve) show any weakness or signs of irritation.
If the cause is unclear, doctors may order additional tests:
| Test | Purpose |
|---|---|
| MRI scan | Detects problems near facial nerves, such as a tumor, aneurysm, or blood vessel pressing on the nerve. |
| Electromyography (EMG) | Measures the electrical activity in facial muscles to find abnormal signals. |
| Magnetic resonance angiogram | Reveals blood vessels touching the facial nerve. |
These tests help doctors distinguish hemifacial spasm from other problems, such as Bell’s palsy, blepharospasm, trigeminal neuralgia, or facial nerve infection.
Imaging and nerve tests are especially useful when symptoms are unusual or before doctors consider surgery.
Treatment
Treatment options for hemifacial spasm aim to reduce muscle twitching and relieve pain. One of the main therapies is botulinum toxin injections.
Doctors inject these shots into the affected facial muscles to reduce movement and usually repeat the treatment every few months. Most people experience fewer spasms after this treatment.
Doctors might also prescribe other medications, including muscle relaxants or anticonvulsant medicines, to help control involuntary movements for some patients.
If symptoms are severe or do not improve with other treatments, surgeons can perform surgical procedures.
In microvascular decompression, the surgeon finds the blood vessel pressing on the facial nerve and places a small cushion between them. This relieves pressure and can stop the spasms.
Other surgical methods, like radiofrequency thermocoagulation, use heat or radio waves to treat the nerve. Below is a summary table:
| Treatment Option | Method | Key Points |
|---|---|---|
| Botulinum toxin | Injections into face muscles | Needs repeating; reduces spasms |
| Medicines | Muscle relaxants, anticonvulsants | May help some patients |
| Microvascular Decompression | Surgical procedure | Relieves pressure on nerve |
| Thermocoagulation | Heat or radio waves on nerve | Targets specific nerve fibers |
Get Ready for Your Visit
Before your appointment, write down your symptoms—how often they happen, when they started, and whether they affect one or both sides of your face. Note if anything makes the twitching worse or better.
Bring a list of current medications, past treatments, and any medical conditions, especially those involving nerves or blood vessels. If you’ve had imaging or nerve tests, try to get copies of the results or have them sent to your doctor.
You may want to prepare questions, such as:
- What is causing the spasms?
- Will the condition go away or get worse over time?
- What treatment options do I have?
- Are there side effects to the treatment?
Having a family member or friend join you can help you remember details and provide support during your visit. Being prepared can make your visit more helpful and give you more confidence in the care plan.
