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KEY POINTS
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Hemifacial spasms are twitching or squeezing of muscles on one side of your face. The spasms are usually painless and you can’t control them. The muscles may twitch even during sleep. They do not go away without treatment.
Hemifacial spasms can happen when something puts pressure on the facial nerve near your brain. This pressure changes the way the nerve works. The pressure may be caused by:
You are also more likely to have hemifacial spasms if you had Bell's palsy at some time in your life. Bell’s palsy is a weakness or paralysis of a facial nerve.
Symptoms may include:
Usually the spasms start around your eyes and spread to other face muscles. Less often they start around the mouth and go up to the forehead.
Your healthcare provider will ask about your symptoms and medical history and do exams and tests such as:
Hemifacial spasms are usually treated with medicine or with surgery.
Very small amounts of botulinum toxin A can be injected into the muscles near the facial nerve. This may weaken or stop the muscle spasms for several months. The shots need to be repeated to keep spasms under control.
Medicines taken by mouth may also help to control the muscle spasms for a short time, but they may cause other side effects. Talk with your healthcare provider about this.
Sometimes surgery is needed to stop the spasms. Surgery is most successful for people who have had symptoms for a short time.
Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
There is nothing you can do to prevent hemifacial spasms.