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Hemifacial Spasm: Uncontrollable Muscle Contraction in the Face

By HERWriter
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The term hemifacial spasm (HFS) refers to involuntary muscle contraction (spasm) on one side (hemi) of the face. HFS is also known as tic convulsif.

One common cause of HFS is a malfunction in the seventh cranial nerve, which is the facial nerve controlling movement of facial muscles. This malfunction can result from an injury or tumor, or Bell's palsy.

Most often, a blood vessel is pressing on the facial nerve. The nerve misfires, and the muscles in the face experience spasm. In many other cases, the source of the disorder is unknown.

Women are more often affected by HFS than men, at middle-age or older.

The most common first symptom will be the twitching of an eyelid, possibly resulting in that eye being permanently closed. Twitching may traverse into the muscles in the cheek, the jaw and neck.

In a small number of cases, symptoms may begin near the chin and work their way upward. These contractions can cause the jaw to open, lips to be distorted, or the tongue to stick out.

In severe cases, all muscles on that side of the face spasm constantly. The individual experiences tonus phenomena, which might be described as a charlie horse of the face. The side of the face seizes up, with the eye closed, cheek contracting, and the jaw clenched.

It is uncommon to have the spasm spread to both sides of the face.

This is not a painful condition. But having one's face twisted into a mask, and being unable to move eyes or lips, causes a myriad of problems. And having one eye refuse to open leads to numerous visual disturbances.

Since these symptoms can occur without warning at any time, this disorder is severely limiting.

Possible treatments are medication, ablative therapy, and surgery.

Medication like muscle relaxants and sedatives have proven to have limited success.

Ablative therapy is injection of botulinum toxin (botox) into the muscles. This weakens facial muscles, and may relieve spasm. Injections may need to be repeated after a few months.

Possible side effects are too much weakness in facial muscles, irritation of the eye and a drooping lid.

Most effective is a surgical procedure called microvascular decompression. A small incision behind the ear, and a tiny opening in the bone may relieve pressure on the facial nerve, thus ending the spasm.

In the majority of cases, partial or complete relief of HFS results.


Mayfield Clinic: hemifacial spasm

eMedicine: Hemifacial Spasm

St. John's Health Center: Hemifacial Spasm

Department of Neurosurgery: Hemifacial Spasm

AANEM: Hemisfacial Spasm

NINDS Hemifacial Spasm Information Page

Visit Jody's website and blog at http://www.ncubator.ca and http://ncubator.ca/blogger

Add a Comment7 Comments

EmpowHER Guest

Two years ago my sister started having facial spasms and was diagnosed with hemifacial spasms. They did eventually stop but now in the past couple of days they had returned along with panic attacks and sore head. She is 35 and trying to live a normal life with this condition she just called me on her way home from work and she had one on the way - its socially a very hard thing to deal with. Does anyone have any advice on how to relax the face to make them less severe?

July 5, 2017 - 2:55am
EmpowHER Guest

i have this and i don't know if i have more variations of it, sometimes i get the clenched jaw and some times one side of my mouth droops so far down like its trying to pull towards my chin, i was ordinary diagnosed with facial palsy but now i don't know if its still facial palsy or it has transcended into something else. lately work has been strenous for me cos its the end of the year and sales is always at the peak by this time but i cant keep up with work cos i always feel faint and weak before my face starts distorting, i really need help, i'm just 27 and i've had dis for 5yrs.... any information will be really helpful. thank u.

December 20, 2012 - 3:02am
(reply to Anonymous)

Hi Anon,
My name is Shana O'Connor and I am EmpowHER's community manager. Thank you for sharing what you are going through. I hope we can help you find the resources and answers you are looking for. I have posted your comment as an ASK on the site so that our moderators and community of women can better find your question and answer with their thoughts.

Here is the link:

Let me know if this is helpful.

December 20, 2012 - 9:24am
EmpowHER Guest

My mother is also facing the same problem, muscle contraction in the right side of the face. Now, whenever she presses that particular side of the face, she also feels vibration the left leg. is there any connectivity??? what is the solution for this???

June 30, 2011 - 2:49am
(reply to Anonymous)

Hi Anon,

Thanks for your question-- I'm sorry your mom is going through this. Has she been diagnosed with anything connecting to the twitching? Twitching is many times connected to Multiple Sclerosis, a spinal injury, or Muscular Dystrophy. However, there is something known as Benign fasciculation syndrome or BFS which is twitching of various voluntary muscles in the body. The twitching can occur in any voluntary muscle group but is most common in the eyelids, arms, legs, and feet.

If your mom is starting to feel symptoms in other parts of her body, she should see her primary care physician or neurologist to help rule out any and all possible causes.

All the best to you and her,


July 1, 2011 - 11:03am

I'm so sorry that you have this.

I know it's a very hard condition to live with.

Thank you for writing and telling us about your situation.

March 25, 2010 - 11:55am
EmpowHER Guest

i hv hemi ficial spams.. its rigth side of my face..its began with eye tics and then its involve my check also..i m hvings thz disorder i hv to much headic .. and my bp is always high....

March 25, 2010 - 11:51am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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