Hemifacial spasm is a neuromuscular disorder that causes spasms from injury, damage, or compression of the facial nerve. These spasms often affect only one-half of the face, although patients can have blepharospasm and hemifacial spasm as well. Hemifacial spasms often persist during sleep.
It is important to rule out a tumor or abnormal vessel pressing on the facial nerve which is often done with MRI imaging. If a tumor or abnormal vessel is present on imaging, a neurosurgeon will be consulted to discuss decompression surgery. Aberrant regeneration of the facial nerve from a prior history of facial trauma or Bell’s Palsy can also occur. If there is no identifiable cause on imaging, treatments may include neurotoxin injections which are usually covered by insurance at about 4-month intervals. Medications can help but are often unpredictable and short-term.