Hemifacial Spasm

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Hemifacial spasm (HFS) is a form of peripheral myoclonus, characterized by progressive, involuntary, irregular, and clonic or sometimes more long-lasting tonic movements of muscles innervated by the seventh cranial nerve on one side of the face. The upper and/or lower eyelids are the most common site of initial involvement, followed by the cheek and perioral regions. Complete unilateral eye closure may interfere with vision and cause social embarrassment. HFS is relatively uncommon but is a disturbing symptom when it occurs. Mean age of onset is 49 years, and there is a slight female preponderance. The most frequent cause of HFS is compression of the facial nerve at the pontine root exit zone by an ectopic anatomical or pathological structure which results in ephaptic transmission.

Supplementary material

The patient exhibits continuous tonic right HFS involving predominantly orbicularis oculi, zygomaticus major, nasalis, and platysma muscles.

Hemifacial spasm.mp4 (MP4 2,425KB)


  1. 1.
    Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. Muscle Nerve. 1998;21:1740–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Adler CA, Zimmerman RA, Savino PJ, et al. Hemifacial spasm: evaluation by magnetic resonance imaging and magnetic resonance tomographic angiography. Ann Neurol. 1992;32:502–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Jitpimolmard S, Tiamkao S, Laopaiboon M. Long term results of botulinum toxin type A (Dysport) in the treatment of hemifacial spasm: a report of 175 cases. J Neurol Neurosurg Psychiatry. 1998;64:751–7.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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