Hemifacial Spasm

Involuntary contraction of one side of the face.

Hemifacial spasm is a rare disease characterized by involuntary contraction of one side of the face. It appears spontaneously and usually worsens progressively. It has an aesthetic and psychologically damaging effect on the patient.

The main cause is similar to that of trigeminal neuralgia: a vascular loop is frequently overlying the facial nerve, promoting, through the continuous pulsing against the nerve, inflammation and involuntary, repeated depolarization.

How it manifests

The involuntary contractions of the muscles of facial expression are predominant around the eyes, gradually progressing to the muscles that contract one half of the mouth. They are intensified by stress:

Imaging diagnosis

Magnetic resonance imaging is the best method for diagnosis, allowing identification of the vascular loop in conflict with the facial nerve.

Management and treatment

Drug treatment has a limited response in this condition. Botulinum toxin acts on the contractions, with a temporary effect. Elderly patients or those with severe clinical comorbidities are not candidates for the surgical procedure: