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Hemifacial spasm
Other Resources UpToDate PubMed

Hemifacial spasm

Contributors: Jamie Adams MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Hemifacial spasm is an involuntary muscle contraction occurring on one side of the face, in one or more muscles innervated by the facial nerve. The disorder can be caused by compression of the facial nerve (cranial nerve VII), such as by an artery or tumor, or it can be idiopathic. Sometimes it occurs after Bell palsy. The condition is more prevalent in older women and Asian populations.

Muscle contractions are frequent but irregular. They are typically brief (a second or so) but can be more prolonged and "tonic," ie, for tens of seconds. They typically start in the eyelid and spread to other muscles in the face. Spasms may be worse in the setting of stress, anxiety, or fatigue.

Symptoms may be controlled by botulinum toxin injections, and in some cases, surgical microvascular decompression is performed.


G51.39 – Clonic hemifacial spasm, unspecified

13753008 – Hemifacial spasm

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Tics
  • Facial myokymia
  • Facial myoclonus
  • Facial chorea
  • Focal motor Seizure
  • Oromandibular dystonia
  • Tardive dyskinesia
  • Multiple sclerosis

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Last Reviewed:06/03/2018
Last Updated:01/17/2022
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Hemifacial spasm
A medical illustration showing key findings of Hemifacial spasm : Chronic duration lasting years, No acute distress, Recurring episodes or relapses, Facial muscle spasm
Copyright © 2024 VisualDx®. All rights reserved.