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Hemifacial Spasm

  • Cynthia M. Johnson, MA
Publication Type:


Hemifacial Spasm


Hemifacial spasm (HS) causes muscles to contract on one side of the face. A person cannot control the spasm.


HS does not always have a cause. It may be due to:

  • A blood vessel pressing on the facial nerve
  • Facial nerve injury
  • Tumor
Muscles of the Face.

Muscles of the Facehttp://services.epnet.com/getimage.aspx?imageiid=798979893DSAE9258e_40018_1.jpgMuscles of the FaceNULLjpgMuscles of the FaceNULL\\hgfiler1\intellect\images\3DSAE9258e_40018_1.jpgNULL130NULL2010-05-20400300325225Copyright © Nucleus Medical Media, Inc.

Risk Factors

HS is more common in older women. It is also more common in people who are Asian.


Problems may be:

  • Twitching of the eyelid muscle that causes the eye to close
  • A mouth that is pulled to one side
  • Spasms of all the muscles on one side of the face


The doctor will ask about symptoms and health history. A physical exam will be done. It will focus on the face.

Pictures of the head may be taken. This can be done with:

Nerve and muscle function may be tested. This can be done with electromyography (EMG).


The goal of treatment is to ease pressure on the nerve. This can be done with:

  • Injections of botulinum toxin (Botox) to temporarily stop spasms
  • Antiseizure medicine

Some people may need surgery to reposition a blood vessel that is pressing on a nerve.


There are no known guidelines to prevent this problem.





  • Hemifacial spasm information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/hemifacial-spasm.
  • OnabotulinumtoxinA. EBSCO DynaMed website. Available at: https://www.dynamed.com/drug-monograph/onabotulinumtoxina.


  • Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.