Botulinum Neurotoxin for Hemifacial Spasm and Facial Synkinesis

Hemifacial spasm is a disorder of recurrent, involuntary twitches of facial muscles that are peripherally induced. It typically begins in middle age and occurs more commonly in women. Most frequently, patients will experience involuntary eye closure and mouth retraction/elevation. The etiology is thought to be due to vascular compression of the facial nerve by an aberrant vascular loop, specifically the posterior inferior cerebellar artery. Botulinum neurotoxin is a safe, effective method to treat hemifacial spasm.