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Hemifacial Spasm (Face Twitching): Symptoms and Causes

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

The beauty of the face is essential for every person. We communicate, read emotions and other signs on a person’s face, and also express our emotions with the help of a face. The facial nerve is responsible for the work of our muscles on the face. However, at some point, this nerve can operate incorrectly. As a result, spasms in the face may develop.

Hemifacial spasm is unilateral painless synchronous facial muscle contractions due to repetitive, involuntary electrical impulses of the 7th cranial (facial) nerve and/or its motor nucleus. This disease is a rather serious problem that can change a person’s life, leading to discomfort and depression. It is vital to start timely treatment to improve the condition.

In our article, we will look at what twitching in the face is, what causes it, and the general symptoms of hemifacial spasm by which you can distinguish it.


Hemifacial Spasm Overview

Hemifacial spasm (HFS, also known as tic-convulsive) is an uncontrollable twitching of the facial muscles on one side of the face. The facial muscles (facial muscles) are controlled by the facial nerve (seventh cranial nerve), which originates in the brainstem and exits the skull below the ear, where it divides into several main branches. These branches run along the face, reaching the mimic muscles. The facial nerve is an exclusively motor nerve, meaning it contains fibres dedicated only to muscles. This nerve sends commands to the muscles that move the eyebrows, eyelids, mouth, and lips, and the platysma in the neck. 

Irritation of the facial nerve causes abnormal electrical impulses within the nerve, which propagate along the nerve fibres and go to the muscles. Once a muscle receives an abnormal signal, it contracts, causing visible twitches. Twitching is usually painless but can be confusing and interfere with normal facial expressions. 

Usually, it involves the entire half of the face, which causes embarrassment in patients. Sometimes there is also a slight degree of facial paralysis, that is, weakness of the facial muscles due to damage to the facial nerve.


What Is Hemifacial Spasm?

Hemifacial twitching (HFS) is a condition that causes the muscles in your face to contract involuntarily. HFS usually affects only one side of your face. It can occur at any age but is most common in adults aged 40–60. Although HFS isn’t life-threatening, it cannot be very pleasant. Keep reading to learn more about the causes and symptoms of hemifacial twitching.


Symptoms of Hemifacial Spasm

Symptoms of hemifacial spasm

Problems with the face can occur from the eyelid and affect other muscles of the face. This can cause the following symptoms:


  • Difficulty in closing eyes.
  • Pain in the affected muscles of the face.
  • Twitching of eyelids.
  • Other twitchings in the area of the face.


Eyelid twitching is the most common symptom, which may start out as an intermittent symptom but can become an ongoing problem over time. If you notice that your eyelid or eye is twitching, you should contact your doctor for help.

These symptoms can vary in intensity from person to person. Some people with HFS only have mild symptoms that do not interfere with their daily activities. For other people, the symptoms can be severe and disabling. 


Remember! It is crucial to understand that muscle spasms in the face can significantly affect your daily life and lead to negative consequences such as the appearance of complexes, depression, and a change in people’s perception of you. If you find any of the above symptoms, you should seek professional help from a doctor as soon as possible so that they can make a timely diagnosis and prescribe the proper treatment. In this case, you can significantly improve your condition and return to everyday life.


Causes of Hemifacial Spasm

The cause of HFS is unknown, but doctors think it happens because of a problem with the seventh cranial nerve. This nerve controls the muscles on the side of the face. In HFS, there is nerve damage or compression. This damage or compression causes the muscles to contract involuntarily. HFS is not contagious and psychological factors do not cause it. 

Causes of hemifacial spasm

The most common cause of HFS spasms is twitching of the facial muscles due to irritation of the facial nerve. This can happen because of a variety of factors, including:

  • Tumours or growths on the facial nerve: While rare, tumours or other growths on the facial nerve can compress and irritate the nerve, causing the twitching.
  • Trauma to the face: trauma to the head or neck can damage the facial nerve and lead to twitching.
  • Diseases that affect the nervous system: Conditions like multiple sclerosis, Parkinson’s disease, and stroke can all lead to twitching in the face.


Psychological Condition Due to Hemifacial Spasm

Due to the fact that this disease is closely related to a person’s appearance, many patients have observed psychological problems and barriers that significantly interfere with a normal life. So, due to muscle spasms in the face, many people don’t have an active lifestyle, face difficulties in communicating with the opposite gender and people in general, receive complexes, and can become anti-social. The end result is depression.

Doctors recommend undergoing psychological support with a psychotherapist for the patient’s condition to improve significantly. With the help of a number of technologies and exercises, patients can gradually return to normal life even with such a disease.


Lonestar Neurology Clinic

As a short reminder, these are symptoms of twitching in the face: 

  • Twitching of the eyelid or corner of the mouth.
  • Jaw pain.
  • Headache.
  • Ear pain.
  • Difficulty closing the eye.
  • Facial drooping.

If you notice those symptoms of face twitch, it’s high time to visit your doctor.

Maintaining an average level of health is vital for every person. However, this is only possible with professional help. Our clinic provides a wide range of services regarding neurological diseases and raises many people suffering from these diseases to their feet.You can contact our clinic for assistance if you want to acquire top-notch, prompt, and efficient therapy and treatment. Use the contact us button, fill out our website form, or call the number 214-619-1910. After your call to our clinic, our manager will get in touch with you and give you all the information you require to get better.



  • How can I stop my hemifacial spasms?

Treatment options include:

  1. Botulinum toxin injections: This treatment involves injecting a small amount of botulinum toxin into the muscles that are twitching. 
  2. Surgery: In some cases, surgery may be necessary to remove the nerve causing the twitching. 
  • Can stress cause hemifacial spasm?

There is no evidence that stress causes or worsens hemifacial spasm. However, stress may play a role in triggering spasms in people already predisposed to the condition. If you have a hemifacial spasm, try to avoid situations that trigger your spasms.

  • Is hemifacial spasm severe?

Hemifacial spasm is a severe condition but can not be painful. If your twitching is severe, it may interfere with your ability to eat, drink, or speak. In rare cases, the hemifacial spasm may be a symptom of a more serious condition, such as a brain tumour.

  • Should I see a doctor for hemifacial spasms?

See your doctor if your twitching is severe or interferes with your daily life. The specialist can rule out other possible causes of facial twitching, such as a nervous system disorder or a brain tumour. 

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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