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Hemifacial Spasm: Diagnosis and Treatment

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

The beauty of our face is an important aspect in the life of every person. We pay attention to beautiful facial features, read emotions using facial expressions, and analyze and communicate using our faces.

The facial nerve is responsible for how our emotions are displayed and how the muscles on our face work. A beautiful smile, dimples on the cheeks, and other cute things that we can do with our facial muscles are achieved through this nerve. However, at some point, everything may not go according to plan and the work of this nerve may be disrupted. This can lead to spasms and unnatural facial expressions.

Do you experience spasms and muscle twitches on one side of your face? If this phenomenon continues for a long time and with frequent attacks, there is a reason for this, which, as a rule, lies in the sensitive nerve fibres in the skull area.


Hemifacial Spasm Diagnosis

The cranial nerves, which also include the facial nerve, run from their origin to the organ they are responsible for through bones and various organs such as blood vessels, bones, and tissues. In some cases, and for reasons still unclear, there may be a physical collision between the nerve and these objects, which puts pressure on the nerve and, over time, leads to its dysfunction. When this situation occurs with the facial nerve, twitching of the facial muscles can develop, in most cases on one side only, which can develop into a serious aesthetic or even medical problem such as hemifacial spasm.

Hemifacial spasm diagnosis

There is no single test that can diagnose this disease. Instead, the diagnosis relies on a combination of medical history, physical examination, and imaging tests:


Medical History

Your doctor will ask about your symptoms and when they started. They will also ask about your medical history, including any previous injuries or illnesses that could be related to your current condition. 


Physical Examination

Your doctor will examine your face for signs of muscle twitching or spasm. They will also check for any weakness or paralysis in the affected muscles. 


Imaging Tests

Imaging tests may be ordered to rule out other conditions that could cause similar symptoms. These tests may include magnetic resonance imaging (MRI), computed tomography (CT), or electromyography (EMG). 

To live a full life and not experience discomfort due to spasms in your face, you should go through all the necessary procedures to determine your disease. Thus, a correct diagnosis can provide up to 50% of your treatment success. Indeed, your chances of success from a timely diagnosis can significantly increase. If you think you may have HFS, see your doctor for an evaluation.


Ways to Treat Hemifacial Spasm

The cause of HFS is unknown, but it is probably because of a problem with the facial nerve or brainstem. The condition is not life-threatening, but it can be painful and debilitating. In some cases, it can lead to social isolation and depression. There is no cure for hemifacial spasms, but there are treatments that can help lessen the symptoms. 

Ways to treat hemifacial spasm

If you’re dealing with this condition, you’re probably wondering what your treatment options are. In this block, we’ll go over all the treatments for hemifacial spasms, so that you can make an informed decision about which one is right for you.

There are three main types of treatments for muscle spasms in the face: medical, surgical, and electrical. Let’s take a look at each one in more detail.


Botulinum Injections

Several different types of medication can be great for treating HFS. Botulinum toxin injections are the most common type of medical treatment for hemifacial spasm. They work by temporarily paralyzing the facial muscles that are affected by HFS. 


Other Medications

Other types of medication that help to treat muscle spasms in face include: anticonvulsants, calcium channel blockers, and steroids. However, these medications are not as effective as botulinum toxin injections and often have more side effects. 



Surgery may be an option if medical treatments don’t work or stop working over time. The most common type of surgery for hemifacial spasms is microvascular decompression (MVD). MVD is a procedure in which the surgeon moves the blood vessels that are pressing on the facial nerve away from the nerve. This relieves the pressure on the nerve and prevents HFS from occurring. Other types of surgery for hemifacial spasm include rhizotomy (a procedure in which the surgeon cuts some of the facial nerves) and pallidotomy (a procedure in which parts of the brain that control movement are destroyed). 


Electrical Stimulations

The doctor places a device under your skin near the affected facial nerve. The device sends electrical impulses to the nerve and helps prevent muscle contractions. 


LoneStar Neurology as Your Healthcare Provider 

To always feel your best, you should carefully monitor your state of health and, at the slightest negative change, seek help from a specialist. So, in our clinic, you will receive the proper course from a team of professionals, the correct diagnosis, timely treatment, and affordable medicine. Simply call the number 214-619-1910 or use the contact us button.


Bottom Line 

You can treat hemifacial spasms in a number of different ways. Surgery to release the nerve that is causing the spasm is typically the best course of action. However, a number of nonsurgical therapy approaches may work in some cases. Talk to your doctor about all of your treatment choices for hemifacial spasms and which one is best for you.



  • Can I treat hemifacial spasms naturally?

Many natural treatments are effective in treating the symptoms of hemifacial spasms. These include things like acupuncture, massage, and meditation. Talk to your doctor about whether or not these treatment options might be right for you.

  • Does ice help hemifacial spasms?

There is no clear evidence that ice helps relieve hemifacial spasm symptoms. However, some people find that it helps to reduce the swelling and inflammation associated with the condition. If you want to try using ice, talk to your doctor first to ensure it is safe for you.

  • Should I see a doctor for hemifacial spasms?

If you are experiencing any symptoms of hemifacial spasm, it is essential to see a doctor so that they can properly diagnose and treat the condition. There are several treatment options available, and your doctor can help you find the one that is right for you.

  • How fast does hemifacial spasm progress?

The rate at which hemifacial spasm progress can vary from person to person. In some cases, the condition may only last for a short period and then go away on its own. In other cases, it may persist for many years. If you have a hemifacial spasm, talk to your doctor about how long it is likely to last and what treatment options are available.

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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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  1. November 5, 2023

    Thank you for the info.. How I wish my hemifacial spasm will go away 😢

    • November 16, 2023

      Me too! I’ve had mine since 2016. My son was 6 months old when it started. I wonder if it had something to do with the epidural.

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