Hemifacial spasm

St George’s Neurosciences Department provides a comprehensive regional and supra-regional service for managing Hemifacial Spasms (HFS). We accept referrals from anywhere within England.

Mr Timothy Jones performs electrophysiologically guided minimally-invasive microvascular decompression surgery. This employs the latest technologies (monitoring of lateral spread depolarisations and cranial nerve monitoring).

Dr Jo Flowers and her team perform Botox therapy.

What is hemifacial spasm (HFS)?

Hemifacial spasm (HFS) is characterised by intermittent, painless and involuntary contraction of the muscles innervated by the facial nerve. It affects one side of the face only and may start by only affecting the muscles around the eye which may progress to involved the entire half of the face. It may be associated with symptoms such as impaired balance (vertigo) and less commonly tinnitus.

What causes hemifacial spasm?

Like trigeminal neuralgia, hemifacial spasm is commonly caused by compression of the nerve which innervates the facial muscles as it exits the brainstem.

Why have I been referred to a neurosurgeon?

In some cases, HFS can be managed with injections of botulinum toxin (botox) into the affected muscle(s) however the most effective procedure for treating and in many cases curing HFS is microvascular decompression surgery.

The team at St George’s perform a significant number of these surgeries every year. When you are referred to Mr Timothy Jones, he will see you in the outpatient clinic to confirm the diagnosis of HFS (this may involve having an MRI scan if you have not yet had a scan) and will discuss the risks and benefits of this procedure.