Hemifacial spasm is involuntary contraction of the muscles on one side of the face, typically caused by vascular compression of the facial nerve (cranial nerve VII) at its brainstem exit.
Key Statistics
- Prevalence: ~11 per 100,000 (women) and ~7.4 per 100,000 (men)
- Mean age of onset: ~45–55 years
- Left side affected slightly more often than right
- Microvascular decompression (MVD) achieves cure in 85–93% of patients with low long-term recurrence
Symptoms
- Twitching that starts around the eye and progresses to cheek and mouth
- Spasms triggered by stress, fatigue, or facial movement
- Persists during sleep (distinguishing it from tics)
- Often unilateral and progressive
Treatment
- Botulinum toxin injections every 3–4 months (symptomatic, ~75–95% response)
- Microvascular decompression (Jannetta procedure) — definitive cure by placing a Teflon pad between the offending vessel and facial nerve
- Medications (carbamazepine, baclofen) — limited efficacy
Common Symptoms
- Involuntary twitching on one side of face
- Eyelid spasms
- Mouth pulling to one side
- Spasms during sleep
- Worsening with stress
Treatment Options
Microvascular decompression
Botulinum toxin coordination
Medical management
Dr. Marcus Stephens
Board-Certified Neurosurgeon
Providing expert hemifacial spasm treatment at Nova Brain and Spine of GA in Hampton, Georgia. Serving patients throughout Southern Georgia and the Atlanta metro area.