Hemifacial Spasm

One side of your face might uncontrollably twitch in a condition called hemifacial spasm. This happens because of a problem with the nerves that control facial muscles. Often, a blood vessel is the culprit. This blood vessel might be pressing on or vibrating against the facial nerve. Other possibilities include damage to the facial nerve itself or a growth (tumor) in the area. In some cases, the reason for the spasms isn't clear.

Hemifacial spasm is a condition causing involuntary muscle movements on one side of the face. These movements, often described as twitching or jerking, are usually:

• One-sided: The spasms typically affect only one side of your face.
• Unintentional: You can't control the muscle contractions.
• Pain-free: These spasms are not typically painful.

The spasms frequently begin in the eyelid, then might spread to the cheek and mouth on the same side of the face. Initially, the twitching may come and go. But over time, often months or years, the spasms become more constant and happen more frequently.

While less common, hemifacial spasms can sometimes affect both sides of the face. Crucially, though, the spasms don't happen simultaneously on both sides; they affect one side at a time.

Hemifacial spasm, a condition causing uncontrolled twitching on one side of the face, is most often caused by a blood vessel pressing on the facial nerve. This pressure can be like a blood vessel getting too close and rubbing against the nerve. Other possible causes include damage to the facial nerve itself, or a growth (tumor) in the area. In some cases, the exact reason for the spasm isn't clear.

Sometimes, hemifacial spasm can seem to start or worsen because of things like:

• Facial muscle movements: Using facial muscles a lot, like constantly frowning or smiling, might make the spasm worse.
• Stress and anxiety: Feeling stressed or anxious can sometimes trigger or worsen muscle tension, which in turn can contribute to the spasms.
• Fatigue: When you're tired, your muscles may be more prone to involuntary contractions, potentially leading to a worsening of hemifacial spasm.

Essentially, while the immediate cause is often a blood vessel touching a nerve, other factors like stress and muscle strain can increase the likelihood of the spasms occurring or becoming more noticeable.

Finding out what's causing hemifacial spasm often starts with a physical exam by a doctor. Sometimes, further tests are needed to pinpoint the problem. One common test is an MRI (magnetic resonance imaging). This test uses a powerful magnet and radio waves to create detailed pictures of the brain and surrounding areas. These detailed pictures can help doctors see if there's anything pressing on the facial nerve.

Another test, called a magnetic resonance angiogram (MRA), uses a special dye injected into a blood vessel. This helps visualize the blood vessels in the head and neck. The MRA can show if a blood vessel is close to or touching the facial nerve, which could be causing the problem.

Not everyone with hemifacial spasm needs an MRI or MRA. These tests might be recommended if a person's symptoms are unusual or if surgery is being considered.

Mayo Clinic has a team of specialists who can provide expert care for hemifacial spasm. They can help you understand your condition and create a treatment plan.