Hemifacial spasm is a neurological condition that causes involuntary twitching or contractions on one side of the face. These spasms may begin near the eye and gradually affect surrounding muscles, including the cheek and mouth. While the condition is not typically life-threatening, it can significantly impact daily life and emotional well-being. Hemifacial spasm treatment focuses on relieving muscle contractions, improving facial symmetry, and addressing the underlying cause.
Hemifacial spasm occurs when a facial nerve—known as the seventh cranial nerve—becomes irritated or compressed, often by a nearby blood vessel. This pressure disrupts normal nerve signaling, leading to involuntary facial muscle contraction. The spasms may appear as mild twitching at first and can progress to more frequent or forceful movements over time.
Diagnosis typically begins with a neurological evaluation and imaging tests, such as magnetic resonance imaging (MRI), to identify nerve compression or other abnormalities.
The most common and effective non-surgical treatment for hemifacial spasm is botulinum toxin injection therapy. This approach temporarily weakens targeted facial muscles, preventing them from contracting involuntarily.
During the procedure, small doses of botulinum toxin are injected directly into the affected muscles. The treatment takes only a few minutes and does not require general anesthesia. Most patients notice improvement within a week, with effects lasting around three to four months. Regular follow-up injections maintain symptom control over time.
For many patients, this method offers substantial relief and can be easily incorporated into a long-term management plan.
In cases where botulinum toxin injections provide limited benefit or symptoms continue to progress, we may recommend microvascular decompression (MVD) surgery. This procedure aims to relieve pressure on the facial nerve caused by a nearby blood vessel.
During MVD, a neurosurgeon makes a small opening behind the ear to access the affected nerve. The vessel pressing on the nerve is gently repositioned, and a protective cushion is placed between them to prevent future contact. The surgery requires general anesthesia and a short hospital stay.
Before beginning hemifacial spasm treatment, patients undergo a thorough evaluation that includes medical history, neurological testing, and imaging studies. This ensures that the selected approach aligns with the cause and severity of symptoms.
Patients receiving botulinum toxin therapy may be advised to avoid blood-thinning medications before treatment to reduce the risk of bruising. Those preparing for surgery will receive preoperative instructions covering fasting, medication adjustments, and postoperative care expectations.
Successful treatment of hemifacial spasm often results in noticeable improvements in comfort, confidence, and daily function. After botulinum toxin injections, most patients can return to regular activities immediately. Side effects, if any, are generally mild and temporary.
Following microvascular decompression surgery, recovery may take several weeks. We advise patients to rest, avoid strenuous activity, and attend follow-up appointments to monitor healing. Physical therapy or facial exercises may be recommended to help restore full muscle coordination.
Hemifacial spasm treatment aims to restore facial function and relieve the discomfort caused by constant muscle contractions. Whether through non-surgical injection therapy or advanced surgical decompression, modern techniques provide effective options tailored to each patient’s condition. A neurologist or neurosurgeon experienced in facial nerve disorders can determine the most appropriate plan based on individual needs. For more information or to schedule an appointment, call our office.
To schedule a consultation, please request an appointment on our website at https://arizonaneurosurgeon.com or call Randall Porter, M.D. at (602) 603-8951 to arrange an appointment at our Phoenix office.
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