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Teri Cook: Hemifacial Spasm

Teri Cook is a brunette woman with wispy bangs. She is smiling. She is wearing gold hoop earrings. Her hair is shoulder length.

The Challenge

Nearly five years ago, Teri Cook felt some twitching in the bottom of her right eyelid that wouldn’t go away. What this 44-year-old from Perth, Australia, thought might be the side effects of a strenuous weightlifting workout soon turned into a health nightmare.


"I was just devastated, and it just got worse and worse.” — Teri


It would essentially rob her of many of the pleasures in her life—attending parties, reading, even going outside to bring in the mail—before sending her thousands of miles away to Pittsburgh for help at UPMC.

After visits to an ophthalmologist and multiple neurologists in Australia, she was ultimately diagnosed with hemifacial spasm, or HFS, a neuromuscular disorder characterized by frequent, involuntary contractions on one side of the face.  Most often, it’s caused by a blood vessel pressing on the facial nerve at the point where the nerve exits the brainstem.

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Cook, who manages the family investment company from home, quickly tried the most common treatment for the disorder—injections of botulinum toxin. By that time, she couldn’t read, work on her computer or safely drive because of the effects of the spasms. She’d become a virtual recluse in her own home, avoiding her husband’s work functions and afraid to show her face to friends and neighbors. The regular shots of botulinum toxin were becoming increasingly less effective and gave her face a frozen, stroke-like appearance, she recalls.

Desperate and miserable, she soon learned of a surgical procedure, called microvascular decompression, that could relieve the pressure on the facial nerve that was causing the problem. Warned by some doctors that the surgery could be “highly risky,” she says, she plunged ahead anyway and had the procedure in Australia in 2011. It worked—but, sadly, only for three days.

"I was just devastated,” says Cook. “And it just got worse and worse."

The Path to UPMC

Determined to find a cure, she continued her online search for a permanent solution and finally found it on a Facebook page for HFS sufferers, which led her to seek care from a neurosurgeon at UPMC.

The Solution

Cook made contact with the UPMC Global Care program, which helps to coordinate care, housing, and other services for international patients. Despite her earlier surgery, MRI images showed that there was still significant compression of her facial nerve by a blood vessel. So she and her husband, Warren, left their 21-year-old daughter behind and made the 35 hour trip from Perth to Pittsburgh—her first trip to the U.S. She then underwent microvascular decompression and was in the hospital for less than 24 hours.

The Results

Since her surgery, Teri has seen remarkable improvement.

“It is the most wonderful feeling when my face is quiet and the drumming in my ear stops! Today while Warren and I were shopping, I was able to feel confident in looking shop-keepers in the face and chatting to them with two open, engaged eyes! What a delicious experience!”



Our patient stories profile a number of patients who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.

Teri's treatment and results may not be representative of all similar cases.

Read More Cranial Nerve Disorder Stories