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 drug, but if drugs are ineffective, surgery may be necessary.
(See also Overview of the Cranial Nerves Overview of the Cranial Nerves Twelve pairs of nerves—the cranial nerves—lead directly from the brain to various parts of the head, neck, and trunk. Some of the cranial nerves are involved in the special senses (such as seeing... read more .)
Hemifacial spasm affects men and women but is more common among middle-aged and older women.
The spasms may be caused by
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.
Botulinum toxin (used to paralyze muscles or to treat wrinkles) is the drug of choice for hemifacial spasm. It is injected into the affected muscles. The same drugs used to treat trigeminal neuralgia Trigeminal Neuralgia Trigeminal neuralgia is severe facial pain due to malfunction of the 5th cranial nerve (trigeminal nerve). This nerve carries sensory information from the face to the brain and controls the... read more —carbamazepine, gabapentin, phenytoin, baclofen, and tricyclic antidepressants Heterocyclic (including tricyclic) antidepressants Agomelatine, a new type of antidepressant, is a possible treatment for major depressive episodes. Several types of drugs can be used to treat depression: Selective serotonin reuptake inhibitors... read more —can also be used.
If drug treatment is 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.