What is hemifacial spasm, and what are the causes?

Written by: Mr Allaaeldin Abumattar
Published: | Updated: 13/04/2023
Edited by: Conor Lynch

In one of our latest articles, Mr Allaaeldin Abumattar, a highly respected and skilled Swindon-based consultant ophthalmic surgeon, details what hemifacial spasm is, outlines the causes of the condition, and reveals whether or not hemifacial spasm could be a sign of a more serious underlying condition. 

What is hemifacial spasm?

Hemifacial spasm (HFS) presents in the fifth or sixth decade of life as recurrent, intermittent, painless, and unintentional contraction of the muscles on one half of the face innervated by the facial nerve. It almost always affects one side of the face, although both sides may be affected in severe cases. 


What are the causes of hemifacial spasm?

Hemifacial spasm (HFS) is commonly caused by compression of the nerve (facial nerve) by a blood vessel. When the blood vessel touches or pulsates against the nerve, it damages the outer surface (the insulation) of it. This causes unplanned and unwanted messages to be transmitted along the nerve. 


These messages provoke unintentional contractions of the muscles, which leads to HFS. It may also be caused by a facial nerve injury or a tumour. Sometimes, though, there is no known cause.


Could hemifacial spasm be a sign of something more serious?

Yes, it can indeed. Less than one per cent of HFS cases are caused by a tumour. Pinpointing the exact cause is not always straightforward. Several tests are available to help determine the cause of the spasms, such as MRI scans to make pictures of structures inside the head and rule out tumours and aneurysms


Studies have shown that the most effective method of hemifacial spasm screening is MRI scans and EMG scans to accurately measure the electrical activity of the muscles. 


What are the possible treatments for hemifacial spasm?

The treatment of choice is an injection of botulinum toxin under electromyographic (EMG) guidance. Botulinum safely and effectively treats most patients, especially those with sustained contractions. Relief of spasms occurs between three to five days after injection and lasts approximately six months.


Medications used in the treatment of hemifacial spasm include carbamazepine and benzodiazepines for non-compressive lesions. Carbamazepine, benzodiazepines, and baclofen also may be used in patients who refuse botulinum toxin injections. 


Compressive lesions need to be treated surgically. Microvascular decompression surgery may be effective for those patients who do not respond to botulinum toxin. 


Is hemifacial spasm genetic?

No. Hemifacial spasms typically begin in the fifth or sixth decade of life. An onset of hemifacial spasms in patients younger than 40 years of age is unusual and often heralds an underlying neurologic illness (eg, multiple sclerosis).


Can hemifacial spasm worsen if left untreated?

Yes. It affects one side of the face and may start by only affecting the muscles around the eye which overtime may progress to involve the entire half of the face or even spread to other parts of the same side of the face and body, including the eyebrow, cheek, the area around the mouth such as lips, chin, jaw, as well as the upper neck.


Mr Allaaeldin Abumattar is an exceptionally distinguished consultant ophthalmic surgeon who can help you if you have recently been or are currently experiencing hemifacial spasm. Book an appointment with him today via his Top Doctors profile.

Mr Allaaeldin Abumattar

By Mr Allaaeldin Abumattar

Mr Allaaeldin Abumattar is an exceptionally well-regarded and highly experienced consultant ophthalmic surgeon who specialises in cataract surgeryage-related macular degeneration (AMD)diabetic retinopathy, retinal vein occlusions as well as glaucoma.  Mr Abumattar moved to Swindon in January 2017, where he is currently the age-related macular degeneration (AMD) clinical lead, and is the ophthalmology clinical tutor for university medical school students. 

Mr Abumattar possesses an extensive amount of experience in relation to the management of eyelid conditions and disorders, such as lower lid and upper lid malposition surgerytherapeutic botulinum toxin injection as an effective treatment option for facial dystonia and thyroid eye disease. Impressively, Mr Abumattar developed and provided a structured approach to both the data collection and decision-making in relation to the overall management of thyroid eye disease, which, in 2014, was presented to The British Oculoplastic Surgery Society. 

Following his graduation in 1994; obtaining a degree in medicine from the established Al Fetah University; Mr Abumattar undertook his training in ophthalmology at both the El Nasir Ophthalmic Hospital and the St John of Jerusalem Eye Hospital. He then moved to the UK in 2001, immediately undertaking training posts at the Ayrshire and Arran Acute Hospitals Trust. Following this, he began at a post at the Stoke Mandeville Hospital, where he was awarded with the SAS (Staff grade and Associate Specialists) Clinical Discretionary Award in 2006. 

Throughout his career, Mr Abumattar has developed quite the interest in the incorporation of standard and premium implant for cataract surgery and also for effectively correcting astigmatism. He has taught and trained many in the area of ophthalmology to-date, and has engaged himself in clinical trials. He also won the Best Presentation Prize in the SAS Regional Academic Study Day, 2013, for his tips on delivering virtually painless ocular injections in the management of age-related macular degeneration study on "Pain Scores Following Intravitreal Injections." In addition, Mr Abumattar most notably held an honorary fellowship post at Moorfields Eye Hospital in 2013. 

Moreover, Mr Abumattar achieved responsibilities as Trust Appraiser, the Director of the Buckinghamshire Postgraduate Ophthalmology Teaching Programme, Member of the Joint Consultation and Negotiating Committee (JCNC) for doctors and dentists in Oxfordshire Deanery, representative in the Royal College of Ophthalmologists SAS group, and SAS representative in Royal College revalidation sub-committee. He was also awarded a Local Clinical Excellence Award in 2021 in recognition for his service to the NHS. 

  • Related procedures
  • Microdermoabrasion
    Dark circles
    Neck lift
    Botulinum toxin (Botox™)
    Dermal fillers
    Facial paralysis
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.