Does one side of your face always twitch? Let's talk about Hemifacial Spasm

It's normal to squint sometimes. But if you find that one side of your face, such as your eye, cheek, or lip, twitches uncontrollably, it's something to be concerned about. This condition is medically known as Hemifacial Spasm. While it can be a bit of a bothersome experience, there is good treatment available so there's nothing to worry about. Let's talk about it in detail.

Simply put, what is Hemifacial Spasm?

Hemifacial Spasm is a neurological condition that causes the muscles on one side of your face to twitch repeatedly and uncontrollably. This can get worse over time.

• "Hemifacial" means "half of the face."
• "Spasm" means "muscle twitching."

This condition is usually most common in adults between the ages of 40 and 60. Also, women are about twice as likely to develop this condition as men.

This can also be called a movement disorder that occurs in the peripheral nervous system of our body.

Are there main types of hemifacial spasm?

Yes, there are two main types of this, depending on how the symptoms progress over time.

1. Primary Hemifacial Spasm: In this type of spasm, the twitching begins in the muscles around the eyes. Gradually, over months or even years, it spreads to the lower part of the face.

2. Secondary Hemifacial Spasm: In this type, the twitching of both the upper and lower parts of the face begins almost simultaneously. At first, it comes and goes, but later it can be constant.

What are the symptoms of this condition?

The main symptom is an uncontrollable twitching of the muscles on one side of your face. This is more common on the left side than the right. It is very rare for it to affect both sides of the face.

Here's how symptoms typically begin and progress:

• It starts with a blink of an eye. This comes and goes.
• After a while, the eye may close on its own .
• Next, you may feel like your eyebrows are growing naturally .
• Later, the muscles on the lower side of the face also begin to tighten. This can cause the mouth to pull to one side .
• Eventually, the muscles on one side of the face may become permanently stretched.

These spasms are usually not painful. However, they can be very uncomfortable and embarrassing when you are in public. These symptoms can be exacerbated by stress, fatigue, eating, and anxiety. Some people experience these spasms while sleeping . This can also disrupt their sleep.

Other symptoms

Some people may experience other things in addition to these main symptoms.

• Hearing a "ticking" sound in the ear
• Ear pain
• Hearing loss (especially secondary)

Why is this happening? What are the reasons?

The main cause of hemifacial spasm is prolonged pressure on the facial nerve (the seventh cranial nerve), which is a major nerve that controls facial movements.

Imagine what would happen if a blood vessel that runs right next to this main nerve that controls the movements of our face were to be squeezed? It's like a stone falling on a water pipe. Then the signals from that nerve would be disrupted. The protective covering of the nerve (the `myelin sheath`) would be damaged. Because of these disrupted signals, the muscles would start twitching involuntarily.

This is the main cause of primary hemifacial spasm .

Secondary Hemifacial Spasm is caused by pressure on the facial nerve due to another medical condition or cause. Some of the causes include:

• An injury near the facial nerve
• Conditions such as Bell's palsy
• Damage to the brainstem due to conditions such as multiple sclerosis or stroke
• Problems with blood vessels in the brain, for example `brain aneurysms`
• Ear infections such as otitis media
• Tumors that develop in the parotid gland, either cancerous or noncancerous
• Structural problems in the lower part of the skull

How does a doctor find this?

If you have these symptoms, a doctor will first examine you physically and perform a neurological exam.

Then, an MRI scan is often recommended to rule out other serious conditions that are causing the symptoms and to find the exact cause of the hemifacial spasm. In the primary type, the blood vessel that is compressing the nerve can usually be found on the MRI.

Sometimes these symptoms can be similar to other conditions, such as `blepharospasm` (a condition in which only the eyelids twitch) or `complex partial motor seizures` (a type of epilepsy). In such cases, the doctor may also perform a test called EMG (Electromyography) if they want to confirm what it is exactly.

What are the treatments for this?

The main goal of treatment is to reduce the frequency and intensity of facial twitching. There are several treatment options depending on the cause and severity of the condition.

Is Hemifacial Spasm a dangerous condition?

Hemifacial spasm itself is not physically dangerous. However, the underlying medical condition that causes it (e.g., a brain tumor) can be dangerous. That's why it's important to see a doctor as soon as you experience symptoms.

In addition, this condition can affect quality of life.

• Sleep disturbance
• Psychological problems such as social anxiety, anxiety, and depression
• Accidents that can occur due to spontaneous eye closure, such as while driving

This condition usually does not get better on its own. However, it has been reported that it resolves spontaneously in about 10% of cases. It is not yet known exactly how this happens.

Hemifacial Spasm is a really annoying condition that interferes with daily life. It's not a good feeling to feel like you can't control your body. But the best thing is that there are now very effective treatments for it. If you also feel that one side of your face is constantly twitching, and it seems to be getting worse, definitely see a doctor. He or she can examine you, find the cause, and give you the best treatment plan for you.