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Feeling the muscles in your face move without your control can be upsetting. In hemifacial spasm, nerve signals to these muscles become disrupted, so muscles contract when they shouldn't.
UPMC experts use a specialized surgery to treat this neurological movement disorder.
Each side of your face has more than two dozen muscles that you use to chew and show emotions.
Twelve nerves (cranial nerves) send electrical signals from your brain to your upper body. Two of these nerves — the facial nerve and trigeminal nerve — control how your facial muscles move.
In hemifacial spasm, these nerves tell muscles on one side of your face to contract, or twitch, for no reason. These twitches usually don't hurt. But over time, they may happen more often.
Hemifacial spasm is a rare neurological movement disorder.
UPMC neurosurgeons specialize in treating hemifacial spasm with microvascular decompression surgery. To make an appointment or talk with a neurosurgery expert:
For the most part, spasms occur when a blood vessel presses on a facial nerve. The pressure disrupts the nerve impulses that cause muscles to contract.
You may also get this issue if you:
Anxiety, fatigue, or stress can also cause the muscles in your face to twitch. Rarely, hemifacial spasm starts for no clear reason.
Hemifacial spasm occurs when facial nerves become irritated. The issue is twice as likely to happen in women than in men.
Middle-aged women, especially those of Asian descent, get hemifacial spasm most often. The issue doesn't tend to run in families.
If not treated, hemifacial spasm symptoms may may get worse, with nearly constant twitches.
UPMC specialists are experts in diagnosing and treating hemifacial spasm. We run specialized tests to detect problems with how the cranial nerves send electrical signals. UPMC surgeons have done hundreds of microvascular decompression surgeries to relieve hemifacial spasm symptoms.
Symptoms of hemifacial spasm include movements you can't control. These movements typically occur on one side of the face. You may notice:
Doctors will do a physical exam and ask about symptoms you're having. They may suggest:
Imaging tests help doctors see what's going on under your skin. To diagnose hemifacial spasm, UPMC specialists may do an MRI.
Specialists use electrodiagnostic medicine techniques to learn more about how your cranial nerves work. Our experts use these painless tests to find disruptions in how nerves send electrical signals to the muscles in your face.
Doctors sometimes treat hemifacial spasm with noninvasive methods, such as:
Although these treatments may relieve symptoms in the short term, muscle twitch often returns. Microvascular decompression surgery offers lasting symptom relief for many people with hemifacial spasm.
During microvascular decompression, surgeons:
When large arteries compress nerves, experts place a small loop around the artery and secure it to your skull (sling technique). This lifts the blood vessel and relieves compression.
Surgeons check your nerve activity throughout surgery to protect the other cranial nerves. With microvascular decompression, UPMC specialists can help stop facial twitch.
Emerson suffered from a facial spasm that caused involuntary twitching for years. Treatment at the UPMC Neurological Institute cured his condition.
Read Emerson's story.
