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If you or someone you care about has been diagnosed with hemifacial spasm, one of your main questions is likely, “What causes hemifacial spasm?

Once you understand the causes and symptoms associated with this condition, you can begin to consider your treatment options.

What is hemifacial spasm?

Hemifacial spasm is a neurological disorder in which one side of the face experiences a twitch or spasms. They can start out subtly, and usually originate around the eye. Unlike the occasional “nervous tic” some individuals experience when under stress (often referred to as a “tic in the eye”), the spasms become more frequent and pronounced and can begin to affect other parts of the face.

Both men and women can develop hemifacial spasm, however, the largest number of sufferers are women. In fact, three women for every man develop this condition. The reason for this disparity in the number is unclear. It has also been found to be more prominent in those of Asian descent.

Hemifacial spasm causes

What causes hemifacial spasm? There are a few reasons hemifacial spasm may occur. Facial nerve compression from a blood vessel is the most common; less likely are multiple sclerosis, vascular malformation, benign tumor compression or facial nerve injuries are the most likely causes.

Vascular compression of the nerve

At the point where your facial nerve exits your brainstem, it must pass through a fairly small area shared with other structures such as blood vessels. The most commonly seen cause of hemifacial spasm is due to the nerve being compressed by an adjacent blood vessel, such as a small artery.

Each time your heart beats, it places pressure on the nerve, causing it to misfire and create the spasms.

Multiple sclerosis

Multiple sclerosis (also called MS), is an autoimmune disease in which the body mistakenly interprets the outer coverings of the nerves as a foreign substance. The immune system attacks the nerve sheath, eating away at it. This exposes the delicate nerve within, creating unwanted symptoms, including those such as hemifacial spasm.

Vascular malformation

Sometimes veins or arteries don’t develop correctly, causing them to take unusual paths throughout the body. In the case of hemifacial spasm, this malformation may occur around or next to a nerve, causing the same compression or even constriction of the facial nerve.

Compression from a benign lesion or tumor

Occasionally, the facial nerve may be compressed by a lesion or tumor growing on the nerve’s sheath. Occasionally, lesions may also occur. Either one of these can press against the nerve, causing it to malfunction and send erroneous impulses, resulting in spasms.

Nerve injury

A nerve injury can lead to hemifacial spasm. There are a number of ways the facial nerve can become injured, but the most common is head or neck trauma that results in the nerve being pinched or stretched. Accidents or falls are some of the most common ways the nerves in your back, neck and head can become damaged.

How hemifacial spasm is diagnosed

The diagnosis and determination of what causes hemifacial spasm are often fairly straightforward. It is isolated to the facial nerve, giving your medical team a clear idea of where to first focus.

A large pool of testing options gives your doctor the ability to explore all possibilities. The presence of a persistent tic that has progressively worsened is the starting point. A preliminary diagnosis is typically made based on the symptoms, then additional testing is performed to try and pinpoint the cause.

Physical exam and history

A thorough medical history will be taken, including any injuries or diseases you’ve had in the past. It’s vital that you don’t leave anything out. Sometimes even the most seemingly inconsequential health event is a large part of the bigger picture.

If you’ve ever injured your head, neck or back, be sure your doctor is aware of this. Even old injuries can have unexpected consequences years after they’ve occurred.

Imaging studies

Diagnostics such as CT scan (computerized tomography) and MRI (magnetic resonance imaging) help to rule out the possibility of a tumor or lesion causing the symptoms. They can also reveal whether or not the spasms may be the result of vascular compression or an injury to the nerve.

Your doctor may recommend using a contrast material injected intravenously to help highlight small details around your facial nerve.

Other tests

In addition, conditions such as multiple sclerosis must be ruled out. Testing for MS can include an MRI to look for lesions on your brain and spinal cord. Blood tests are also performed to help rule out any other diseases or conditions that might be similar to the symptoms of multiple sclerosis.

If you suffer from MS, be sure your doctor is aware of this fact. It may play a large part in helping accurately diagnose the cause of your hemifacial spasm.

Regardless of the origin of your condition, hemifacial spasm is treatable.

Explore your options in the New Jersey and Tristate area when choosing a surgeon. With a good medical team behind you, you can rest assured that you’ll receive an accurate diagnosis and the best treatment available.


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