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Hemifacial Spasm

Hemifacial spasm is a nervous system disorder that causes uncontrollable spasms of the facial muscles. It results from uncontrolled contractions of the muscles of the face and is caused by compression of the facial nerve at the brainstem, usually by a displaced artery or vein.

Hemifacial Spasm Symptoms:

Hemifacial spasm is characterized by a twitching or spasm in the facial muscles. Though it is not a medical emergency, the spasms can become severe and cause discomfort in patients. The most common symptoms of hemifacial spasm include:

  • Eyelid twitches
  • Mouth twitches, which can cause the mouth to pull down on one side
  • Facial twitching localized to one side of the face
  • Changes in hearing

Though most patients only experience spasms on one side of the face, some may experience twitching on both sides. In addition, ear pain or a clicking sound in the ear can be symptoms of hemifacial spasm. Hemifacial spasm is more common in women than men and typically affects those over 50. An MRI is the most common way to diagnose hemifacial spasm.

Hemifacial Spasm Treatment:

No drug has proven effective in preventing or stopping hemifacial spasm. However, muscle relaxants of other nerve medications may be prescribed to ease symptoms. Additionally, injections and surgical treatments can be used to treat hemifacial spasm.

  • Botulinum toxin (Botox) injections have been used to weaken the muscles of the face, reducing spasms. Botox injections are only a temporary treatment, though, and usually have to be repeated multple times per year.
  • Microvascular decompression is a surgical procedure that can be used to ease the pressure on the facial nerve. During MVD, a neurosurgeon uses a microscope to identify the artery compressing the facial nerve. Then, a pad is placed between the artery and the facial nerve. Microvascular decompression surgery is highly effective and can provide permanent treatment for hemifacial spasm patients.

Treatment for hemifacial spasm will depend on the individual patient and the progression of symptoms.

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We specialize in Hemifacial Spasm Treatment.

At Nashville Neurosurgery Associates, we are proud to be one of the region’s leading neurosurgical centers. Dr. Ulm is a nationally recognized expert in the care and treatment of hemifacial spasm.


Fellowship-Trained Neurosurgeon


Board-Certified Neurosurgeon

Charlie Spradley

Charlie came to Dr. Ulm after diagnosis and unsuccessful treatment of his hemifacial spasms. After meeting and discussing his options with Dr. Ulm, Charlie and his wife, Jane, decided he should have Microvascular Decompression Surgery, the only known permanent treatment for hemifacial spasm. Since surgery, Charlie has been spasm free.

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