To diagnose your condition, your doctor will conduct a physical examination and check for signs of hemifacial spasm. To determine the cause of your condition and develop the most appropriate treatment for your condition, imaging tests may be necessary.
Magnetic resonance imaging (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 for hemifacial spasm may include:
- Botulinum injections. Your doctor may inject botulinum toxin (Botox) 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.