Hemifacial Spasm

Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions in the muscles on one side of the face.

Hemifacial spasm doesn't always have a specific cause. It may occur as a result of:

  • A blood vessel pressing on the facial nerve
  • Tumor
  • Facial nerve injury
  • Bony or other abnormalities that compress the nerve

Hemifacial spasm is more common in middle-aged and elderly women. It is also more common in people of Asian descent.

Common Symptoms 

You may experience the following symptoms:

  • Intermittent twitching of the eyelid muscle
  • Forced closure of the eye
  • Spasms of the muscles of the lower face
  • Mouth pulled to one side
  • Continuous spasms involving all the muscles on one side of the face

Diagnosis & Treatment at UVA

Your doctor may perform tests, including:

  • Angiography 
  • MRI scans
  • CT scans

Talk with your doctor about the best treatment plan for you.


Your doctor may recommend antiseizure medications to help relieve your symptoms.

Botulinum Toxin Injections

Injecting botulinum toxin into the affected muscles can stop eyelid spasm for several months. You may have to repeat these treatments, usually several times a year. 


Microvascular decompression surgery repositions the blood vessel away from the nerve. This is successful in cases of hemifacial spasm where the cause is suspected to be a blood vessel compressing the facial nerve.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.