What is Hemifacial Spasm?

Hemifacial spasm occurs most often in women, in middle to later life. 

"The first symptom .. of hemifacial spasm is usually an intermittent twitching of the eyelid muscle which can lead to forced closure of the eye. The spasm may then gradually spread to involve the muscles of the lower face, which may cause the mouth to be pulled to one side.  Eventually the spasms involve all of the muscles on one side of the face almost continuously. The condition may be caused by a facial nerve injury or a tumor, or it may have no apparent cause. Very commonly, hemifacial spasm is caused by a blood vessel pressing on the facial nerve."

[Reference:"Hemifacial Spasm,Fact Sheet"
National Institute of Neurological Disorders and Stroke]

The early stages of this disorder may also be called "Benign Essential Blepharospasm", though it is unlikely to be perceived as "benign" by a patient who has significant symptoms. Another term that may be used for the effect of the disorder on the eyelids, is "Miege Syndrome." 

How is Hemifacial Spasm Diagnosed?

This disorder is diagnosed based on the patient's observed symptoms.  Most typically, hemifacial spasm does not directly create face pain.  Thus if pain is present, additional neurological assessment may be medically indicated.

How is Hemifacial Spasm Treated?

"No drug has proven effective in preventing or stopping hemifacial spasm. Muscle relaxants and the drugs used for trigeminal neuralgia commonly are given to patients with hemifacial spasm, however they rarely help. In the past, attempts were made to cut or crush the branches of the facial nerve. However, these destructive procedures were associated with facial paralysis and when the paralysis recovered the spasms returned." 

Non-surgical treatment of hemifacial spasm may involve repeated injections of Botulinum-A toxin to weaken the muscles of the face and reduce the more pronounced effects of spasm.  Periods of effectiveness for such injections are highly variable between patients.

Where Can I Find a Healthcare Professional Who Treats Hemifacial Spasm?

The Treatment Team at WPAHS
Peter Jannetta, M.D., Professor of Neurosurgery, Allegheny General Hospital. Jack Wilberger, M.D., Vice Chairman (Academic), Division of
Neurosurgery.  Professor of Surgery (Neurosurgery),  Medical College of Pennsylvania and Hahnemann University 
  • Medical Career and Accomplishments
  • Treatment Interests: Neurotrauma; epilepsy surgery; pain 
  • Publications (Abstracts) from Pub Med
  • To contact Dr. Wilberger
  • Jon Brillman, M.D.  Director, Division of Neurology,  Professor of Neurology, Medical College of Pennsylvania  and Hahnemann University
  • Medical Career and Accomplishments
  • Treatment Interests:
  • Publications (Abstracts) [Note: J Brillman and JC Brillman are not the same person]
  • To contact Dr. Brillman
  • Moises A. Arriaga, M.D.,   Adjunct Associate Professor of Surgery   (Otolaryngology and Neurosurgery), MCP Hahnemann University
  • Medical Career and Accomplishments
  • Treatment Interests: Neurotology/otology; facial nerve disorders; balance disorders; hearing loss; skull base tumors; Meniere's Disease, Vertigo & Tintinitis
  • Publications (Abstracts from Pub Med) 
  • To contact Dr. Arriaga
  • D. Kyle Kim, M.D., Ph.D., Assistant Professor of Neurosurgery,  MCP Hahnemann University
  • Medical Career and Accomplishments
  • Treatment Interests:
  • Publications (Vitae)
  • To contact Dr. Kim
  • Patient Support Groups and Bulletin Boards

    Additional Information on the Internet

    Healthlink USA -- http://healthlinkusa.com/375.html - links to websites for diagnosis, treatment, patient support, etc.

    Surgical Treatment of Trigeminal Neuralgia and Hemi-facial Spasm -- http://www.neurosurgery.ufl.edu/FacultyPage/TicBrochure.html-- Albert L. Rhoton, Jr., MD, University of Florida.



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    Site Index
    Frequently Asked Questions on Healthcare
    Face Pain Overview  * Trigeminal NeuralgiaHemifacial Spasm  * Meniere's Disease  * Vertigo * Tinitis * Hypertension * Torticollis and Spasmodic Torticollis


    For questions or comments, please contact:
    aghneuro@wpahs.org * Department of Neurosurgery *
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    Pittsburgh, PA 15212 * (412) 359-6200 * 
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    Last Updated: August 31, 2000
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