Hemifacial spasm

Hemifacial spasm is a nervous disorder associated with abnormal and involuntary movement of muscles associated with facial expression.

It may be due to an artery or vein compressing the facial nerve or associated with a tumor near the facial nerve. In some instances, no clear association is established.

Besides a full neurologic examination, work up should include imaging studies such as an MRI, with or without MRI angiography, which may show the offending vessel compressing the facial nerve.

Treatment consist of serial Botox injections, trying to paralyze facial expression muscles, or medical therapy (including anti convulsive drugs) trying to diminish the characteristic tic like movements. However, definitive management is through a surgical procedure known as microvascular decompression.

The surgical intervention consists of a small skin incision, followed by a small cranial opening in order to access the nerve and place a sponge-like material in between the offending vessel and the nerve.