Hemi-Facial Spasm

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About Hemi-Facial Spasm

General Information

  • Hemifacial spasm involves muscles spasms on one side of the face caused by compression of a facial nerve by a blood vessel, most often an artery. On occasion, benign tumors, certain vascular malformations, multiple sclerosis or adhesions will cause hemi-facial spasm.


  • This condition primarily consists of involuntary, painless and intermittent contractions of the muscles of the face on one side. The spasms may be limited to the upper or lower half only, and excess tearing may occur.
  • The condition usually begins with occasional contractions of the muscles around the eyes and slowly progresses to involve the entire half of the face.
  • Symptoms may be present during sleep.


  • In addition to clinical findings of symptoms, a magnetic resonance imaging (MRI) brain scan is recommended for most patients to rule out the possibility of tumor or vascular malformation.


  • Relief from hemifacial spasm generally requires surgery. The surgical procedure of choice involves microvascular surgery to physically move the offending blood vessel off of the nerve.
  • Early, mild cases may be managed with observation.
  • Local injection of botulinum toxin into the affected muscles may be effective in some patients.


  • Duration of the symptoms prior to surgery can predict outcome. Shorter is better. Also, younger patients have better outcomes.
  • About 80 percent of patients see full relief from symptoms, 10 percent some improvement and 10 percent no relief.

The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians. UCLA Neuro ICU Family Guide