Diagnosis at Mayo Clinic

Mayo Clinic doctors trained in brain and nervous system conditions (neurologists) and other doctors diagnose people who have hemifacial spasm. In Mayo Clinic's efficient system, your evaluation may be completed within days, not months.

To diagnose your condition, your doctor will conduct a physical examination and check for signs of hemifacial spasm. Your doctor may order imaging tests to diagnose your condition, determine the cause of your condition and develop the most appropriate treatment for your condition.

Your doctor may order a magnetic resonance imaging (MRI) test. An MRI uses powerful magnets and radio waves to create detailed images of your head and determine the cause of your hemifacial spasm. Your doctor may inject a contrast dye into a blood vessel (magnetic resonance angiogram) to look for any abnormal blood vessel that may be irritating the facial nerve.


Treatment at Mayo Clinic

Mayo Clinic doctors trained in brain and nervous system conditions (neurologists), brain and nervous system surgery (neurosurgeons), and other areas evaluate and treat hemifacial spasm. Doctors will educate you about your condition and work with you to determine the most appropriate treatment for you.

Your treatment may include:

  • Botulinum injections. Your doctor may inject botox (botulinum toxin type A or type B) into the affected muscles, which temporarily paralyzes those muscles. You'll need additional treatments every few months.
  • Other medications. Medications, including anticonvulsant drugs, can relieve hemifacial spasm in some people.
  • Microvascular decompression surgery. In this surgery, your surgeon makes an opening in your skull and opens the covering of your brain (dura) to expose the facial nerve as it leaves the brainstem.

    Your surgeon locates the blood vessel pressing on or irritating the facial nerve and puts a spongelike material between the nerve and blood vessel, removing the pressure on the nerve. This surgery often can relieve hemifacial spasm.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Hemifacial spasm care at Mayo Clinic

Sept. 19, 2014
  1. NINDS hemifacial spasm information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/hemifacial_spasm/hemifacial_spasm.htm. Accessed Aug. 4, 2014.
  2. Hemifacial spasm. The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/neurologic_disorders/neuro-phthalmologic_and_cranial_nerve_disorders/hemifacial_spasm.html. Accessed Aug. 4, 2014.
  3. Nguyen TT, et al. Nonepileptic paroxysmal disorders in adolescents and adults. http://www.uptodate.com/home. Accessed Aug. 4, 2014.
  4. Cook AJ. Decision Support System. Mayo Clinic, Rochester, Minn. July 9, 2014.