The Canadian Movement Disorder Group
Thiscondition results in the facial muscles on one side suddenly contracting causing twitching or jerking (especially around the eye). It results from irritation of the facial
nerve within the skull by a loop of a artery which has moved with aging into a position that causes the pulsations to repeatedly strike the nerve. This eventually creates the
situation where spontaneous electrical "sparks" originate and travel down the nerve to activate the muscles on one side of the face to contract.
Treatment of Hemifacial Spasm
Medications (Lorazepam, Diazepam, Carbamazepine, Baclofen) can be used to treat this condition but the success rate is approximately 30%.
Botulinum Toxin Injections:
Botulinum Toxin injections will control the spasms > 90% of the time. These provide only temporary relief and need to be repeated every 3-4 months to maintain control. Side effects are minimal usually, and include dryness, tearing, or drooping of the eye lids. Double vision is rare. These side effects are temporary as they recover as the injection wears off. It may not be possible with this treatment to stop the cheek spasm without some transient facial drooping.
Surgery can cure this condition. The procedure involves a general anesthetic. The neurosurgeon through a opening in the skull behind the ear (under microscopic guidence)
moves the offending artery away from the facial nerve and/or places protective padding between the nerve and artery. The success rate and complication rate depend on the
expertise and experience of the surgeon. Success rates of 70 - >90% have been reported. Risks include deafness on the side of the operation in up to 3%, and rarely permanent facial droop, or stroke.