The atypical form presents with involuntary tonic and clonic movements of the orbicularis oris and then spreads up the face to the eye. Pulsatile tinnitus may also be present if the tensor tympani is involved. [eyewiki.aao.org]

Although partial facial weakness was present in 60% of the cases, it invariably disappeared within 1 to 4 months. Only three patients experienced recurrence of spasm. In two of them, recurrence followed low-temperature coagulation. [ncbi.nlm.nih.gov]

The disorder presents in the fifth or sixth decade of life, almost always unilaterally, although bilateral involvement may occur rarely in severe cases. [emedicine.medscape.com]

• Corneal Irritation

  Blepharospasm - Bilateral blepharospasm (eyelid spasm) is most commonly the result of dry eyes, corneal irritation or benign essential blepharospasm (BEB). The prevalence of blepharospasm in the general population is approximately 5 in 100,000. [blepharospasm.org]

• Facial Pain

  Hemifacial spasms can be accompanied by trigeminal neuralgia (TN) and cause facial pain, but it is not common. [nspc.com]

  (See Doctors Who Treat Hemifacial Spasm or find out more about our Facial Pain Program .) Request an Appointment Refer a Patient Reviewed by: Jared Knopman, M.D. Last reviewed/last updated: October 2017 Illustration by Thom Graves, CMI [weillcornellbrainandspine.org]

  This condition is related to trigeminal neuralgia —an irritation of the fifth cranial nerve that causes severe facial pain. [mayfieldclinic.com]

  These points help with deviation of the mouth and eye, drooping and twitching eyelids and facial pain. Stomach points 2, 4 and 6 are also recommended for mouth deviation, drooling, numbness in the face and contraction of facial muscles. [livestrong.com]

• Facial Grimacing

  While this prevents the facial grimacing seen in HFS, it also prevents normal facial movement at the sites of injection. [blepharospasm.org]

  Patients who have been exposed to neuroleptic agents (such as haloperidol) may develop stereotypical movements of the face, neck, trunk and limbs called tardive dyskinesia. 25 Actions such as ‘marching in space’, ‘truncal rocking’, ‘facial grimacing’ [qjmed.oxfordjournals.org]

• Radiculitis

  Range G50-G59 Nerve, nerve root and plexus disorders Type 1 Excludes current traumatic nerve, nerve root and plexus disorders - see Injury, nerve by body region neuralgia NOS ( M79.2 ) neuritis NOS ( M79.2 ) peripheral neuritis in pregnancy ( O26.82- ) radiculitis [icd10data.com]

• Focal Neurological Deficit

  Nevertheless, it is important to perform a careful neurological examination in all HFS patients for evidence of focal neurological deficits. Imaging is also suggested for patients who are amenable to surgery after failed conservative treatment. [qjmed.oxfordjournals.org]

CONCLUSIONS: Ultrasound and water capsule-guided local injection of botulinum toxin type A treatment is a safe, effective, and simple treatment for patients with facial spasm. [ncbi.nlm.nih.gov]

Surgery for Hemifacial Spasm For some patients, surgical treatment may be the best treatment options. After a consultation with Dr. Azizzadeh, he may determine that microvascular decompression surgery is the best treatment. [facialparalysisinstitute.com]

Prognosis The prognosis for each patient varies according to the severity of the condition. Some patients are successfully managed with minimal intervention. Others require more than one form of treatment before they are free of the condition. [columbianeurosurgery.org]

[…] causes of hemifacial spasm have been reported including: vascular compression as discussed above: most common cholesteatoma schwannoma meningioma intracranial lipoma arteriovenous malformation multiple sclerosis : very rarely implicated Treatment and prognosis [radiopaedia.org]

Prognosis is dependent on how you respond to treatments; you may have lasting effects for the rest of your life. [livestrong.com]

Risk Factors Facial trauma Cranial nerve seven injury Bell’s Palsy Atherosclerosis Family History Pathophysiology The pathophysiology is not well understood and likely varies by etiology. [eyewiki.aao.org]

Microvascular decompression surgery for hemifacial spasm: Classic intraoperative findings Hemifacial spasm (HFS) is a cranial nerve hyperactivity disorder most likely caused by neurovascular conflict (compression) as one of its underlying etiological [neurosurgicalatlas.com]

This condition is similar in etiology to trigeminal neuralgia, an irritation of the fifth cranial nerve that causes severe facial pain. Both hemifacial spasm and trigeminal neuralgia are caused by nerve compression from a blood vessel. [saratoga-ophthalmology.com]

Less than 1% of cases are caused by tumor.[11][12] Hemifacial spasm is much more common in some Asian populations.[1] Several families with hemifacial spasm have been reported, suggesting a genetic etiology or predisposition in some cases. [en.wikipedia.org]

Epidemiology Rare disease (8-15 out of 100,000 people in the US)[1] More common in women than men ( 2x more common in women) Most common in middle-aged and older people (typical age of onset 50-60 years old) Etiology There are a number of known causes [eyewiki.aao.org]

Epidemiology Hemifacial spasm affects all races equally. There is a slight female preponderance. Idiopathic hemifacial spasm typically begins in the fifth or sixth decade of life. [emedicine.medscape.com]

Nutt JG: Epidemiology of dystonia in Olmstead County. Paper presented at: The Second International Dystonia Symposium ; May 9–12, 1986; New York. Google Scholar 4. [link.springer.com]

Therefore, the pathophysiologic mechanism of tinnitus accompanied by HFS may be different from the pathophysiological mechanism of tinnitus alone. [bmcneurol.biomedcentral.com]

A review of pathophysiology. Acta Neurochir (Wien). 1991. 113(1-2):24-30. [Medline]. Cruccu G, Inghilleri M, Berardelli A, et al. Pathophysiology of hemimasticatory spasm. J Neurol Neurosurg Psychiatry. 1994 Jan. 57(1):43-50. [Medline]. Elston JS. [emedicine.medscape.com]

Risk Factors Facial trauma Cranial nerve seven injury Bell’s Palsy Atherosclerosis Family History Pathophysiology The pathophysiology is not well understood and likely varies by etiology. [eyewiki.aao.org]

While this prevents the facial grimacing seen in HFS, it also prevents normal facial movement at the sites of injection. [blepharospasm.org]

Although these medicines can help to prevent spasms, they may also make you feel drowsy and lethargic. It can also often take a little time to find the best dosage. [medic8.com]

Hemifacial Spasm - After Surgery Back to Top Prevention There are no current guidelines to prevent hemifacial spasm. [swedish.org]

Prevention There is no known prevention for hemifacial spasm. How is it diagnosed? At Medanta, following technologies may be used to identify hemifacial spasm: ... [medanta.org]