Why is my left cheek twitching
Hemifacial Spasm - Mayo Clinic
0:00 / 0:00
Timecodes:
hello my name is dr. Michael link I'm a
neurosurgeon at the Mayo Clinic in
Rochester Minnesota I'm going to discuss
just a little bit about hemifacial spasm
hemifacial spasm is really quite a rare
disorder the exact etiology is not known
but it presents usually starting is just
a faint twitching around one eye and
then over time and typically spreads to
involve the entire face and produces a
very characteristic Aric turistic
rhythmic twitching of the face that
initially may be only noticeable to the
patient but eventually becomes quite
obvious even a casual observer it's
typically a not painful not associated
with any sensory changes or numbness of
the face but as it gets more progressive
it can certainly interfere with daily
life can interfere certainly in social
situations but also even with reading or
trying to watch TV
if the face is constantly twitching or
pulling up there's no specific way to
diagnosis other than looking at the
patient and seeing the twitching of the
face sometimes an electrical test called
an electro Maya graph or EMG can be
helpful in finding the characteristic
electrical findings on that test an MRI
scan is often performed to make sure
there's no underlying cause such as a
benign tumor which would be very very
rare typically what we think the cause
is is a normal artery of the brain that
has gotten elongated and is pushing on
the facial nerve
the treatments fall into three big
groups one option is medical treatment
with medications that sort of calm the
nervous system down these are
medications that were initially
developed to treat seizures tegretol or
carbamazepine is one example neurontin
or gabapentin is another example
sometimes those are effective a simple
way to treat the symptoms with botulinum
toxin injections into the muscles of the
face or Botox while that doesn't stop
the electrical discharge from the nerve
masks the symptoms by calming the
muscles down in the face some patients
only need those injections you know a
couple times a year sometimes if the
spasm is quite severe and progressive
they need to have them much more
frequently the only real definitive
treatment is an operation in which we go
in and actually look at the facial nerve
and look for that artery pushing on the
nerve if we're able to find that and we
move the artery away we Pat it up with
some Teflon felt and in about 70 percent
of patients the twitching goes away
there's obviously some risk with
undertaking that operation but the risks
aren't great then once again the success
rate is about 70 percent although a rare
disorder we have a fairly extensive
experience here at Mayo Clinic and we
work as a multidisciplinary team
involving the neurologists and
neurosurgeons
![[E004] Twitching of Eyelid or Face Muscle](https://img.youtube.com/vi/i4_11oltvuc/mqdefault.jpg)
