​Hemifacial Spasm (Facial Twitch)

Diagnosing Hemifacial Spasm

Your doctor will perform a physical exam and will ask about any symptoms you are having.

Hemifacial spasm symptoms

Symptoms may include:

• An intermittent twitching in the eyelid muscle, which can lead to forced closure of the eye.
• This spasm may gradually spread to the muscles of the lower face, which may cause the mouth to be pulled to one side.
• In rare cases, doctors may see individuals with spasm on both sides of the face.

Hemifacial Spasm Treatment

Surgery is the preferred treatment for hemifacial spasm.

Microvascular decompression surgery

At UPMC, the treatment of choice for severe hemifacial spasm is microvascular decompression. Advances in instruments and techniques have made this treatment option more effective in recent years.

Microvascular decompression is a surgical procedure that relieves abnormal compression of a cranial nerve. The surgery consists of a linear incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar.

Under the view of a microscope or endoscope, the doctors detect the area where the blood vessel is affecting the nerve and then separate them, leaving a Teflon "pillow" in between.

During surgery, the doctors monitor facial nerve irritability to identify the blood vessel causing the nerve compression, making cure more likely. Monitoring also helps doctors to avoid damaging hearing and facial nerves.

Our neurosurgeons sometimes use endoscopes that allow them to look around corners as they operate, identify hidden blood vessels, and minimize the impact on sensitive brain tissue.