- Overview of the Cranial Nerves
- Conjugate Gaze Palsies
- Internuclear Ophthalmoplegia
- Third Cranial Nerve (Oculomotor Nerve) Palsy
- Fourth Cranial Nerve (Trochlear Nerve) Palsy
- Sixth Cranial Nerve (Abducens Nerve) Palsy
- Trigeminal Neuralgia
- Hemifacial Spasm
- Bell Palsy
- Glossopharyngeal Neuralgia
- Hypoglossal Nerve Disorders
Twitching may occur only occasionally at first but may become almost constant.
Doctors diagnose hemifacial spasm based on symptoms but do magnetic resonance imaging to check for other disorders that can cause similar symptoms.
Hemifacial spasm is treated with botulinum toxin or another medication, but if medications are ineffective, surgery may be necessary.
Hemifacial spasm affects men and women but is more common among middle-aged and older women.
The spasms may be caused by
An abnormally positioned artery or loop of an artery that puts pressure on (compresses) the facial cranial nerve where it exits the brain stem
Symptoms of Hemifacial Spasm
Muscles on 1 side of the face twitch involuntarily, usually beginning with the eyelid, then spreading to the cheek and mouth. Twitching may be intermittent at first but may become almost continuous.
Hemifacial spasm is essentially painless but can be embarrassing and look like a seizure.
Diagnosis of Hemifacial Spasm
A doctor's evaluation
Magnetic resonance imaging
Hemifacial spasm is diagnosed when doctors see the spasms.
Magnetic resonance imaging (MRI) should be done to rule out tumors, other structural abnormalities, and multiple sclerosis, which can cause similar symptoms. Also, MRI can usually detect the abnormal loop of artery pressing against the nerve.
Treatment of Hemifacial Spasm
Botulinum toxin
Sometimes surgery
Botulinum toxin (used to paralyze muscles or to treat wrinkles) is the medication of choice for hemifacial spasm. It is injected into the affected muscles. The same medications used to treat trigeminal neuralgia—carbamazepine, gabapentin, phenytoin, baclofen, and —carbamazepine, gabapentin, phenytoin, baclofen, andtricyclic antidepressants—can also be used.
If medications are unsuccessful, surgery (called vascular decompression) may be done to separate an abnormal artery, if present, from the nerve by placing a small sponge between them.
Drugs Mentioned In This Article
