Reviewed by Dr Andre Budihardjo, MM, Physician Sam Ng Teck Xian and Physician Wong Si Xuan

Can You Fully Recover from a Hemifacial Spasm?

Published March 28, 2023| 5 min read

Involuntary twitching on one side of your face? It could be a hemifacial spasm. Learn its causes and treatments.

Woman with a concerned expression holds her chin, one side of her face slouching.

You may experience eye twitching when you’re stressed. But if the twitching on your face goes beyond the occasional eyelid tremor, it could be a hemifacial spasm. This condition is a neurological disorder in which the muscles on one side of your face spasm involuntarily.

A hemifacial spasm is quite rare and typically affects middle-aged Asian women. Don’t worry, as the condition is treatable during the early stages. Find what the symptoms and causes are and natural and clinical treatment options that can help manage the condition holistically.

What Are the Symptoms of a Hemifacial Spasm?

Symptoms can develop in the following progression:

Twitching on the eyelid that comes and goes
Spasms force the eyelid to close

Spasms spread to the lower face, pulling the mouth to one side
Spasms affect all the muscles on the entire side of the face

Hemifacial spasms usually happen on the left side of the face. Spasms on both sides of the face are rare.

Possible Causes of Twitching on One Side of the Face

Hands holding mugs of coffee together. — Stimulants like caffeine can worsen hemifacial spasm.

Hemifacial spasm is a result of facial nerve compression, usually by a nearby blood vessel bulging or shifting. This compression destroys the myelin sheath of the nerve and causes the over-firing of electrical impulses to the facial muscles.

Hypertension is found to be prevalent in 40% of hemifacial spasms. An overwhelming feeling of stress, fatigue, and anxiety may contribute to the compression. And if you enjoy coffee, beware, because stimulants like caffeine can worsen it.

The twitching may also be a secondary symptom to these conditions:

Traumatic injury
Bell’s palsy
Brainstem lesions (multiple sclerosis, stroke)

Tumours in the blood vessel or salivary glands
Ear infections
Structural abnormalities in the skull

This neurological disorder is also recognised in Traditional Chinese Medicine (TCM).

“TCM practitioners believe that hemifacial spasm is usually caused by the Deficiency of vital qi (vital life force) and various other factors such as Wind, Cold, Phlegm, and Stasis. This results in poor blood and qi circulation as well as malnutrition in the muscles, tendons, and meridians.

Eu Yan Sang Physician Sam Ng Teck Xian

Treatment and Prevention

Hemifacial spasms don’t go away on their own. In some instances, they may lead to either facial paralysis, dizziness or hearing loss.

Options for clinical interventions

If you suspect you might have this condition, speak to your doctor immediately.

If your diagnosis is confirmed, conventional treatments in Western medicine include:

Anticonvulsant oral drugs such as carbamazepine, gabapentin, benzodiazepines, and baclofen
Botox injections
Microvascular decompression surgery (if the above treatments aren’t possible or don’t work)

While anticonvulsant drugs may stop the twitching temporarily, they can cause severe side effects. Botox injections may provide temporary relief, but you’ll require multiple treatments, which can be costly. Another option is surgery, which has an 80% to 88% average success rate but also comes with higher risks.

TCM treatment options

TCM practitioners usually treat the condition by focusing on modalities that:

Dispel Wind and Phlegm to promote blood circulation

Strengthen the Spleen to prevent Phlegm and Stasis
Invigorate qi to maintain optimal circulation

Herbal therapy

Cup of rose tea next to a jar of dried rose petals on a rustic wooden table. — Herbal therapy like rose tea can be part of stress management practice to prevent nerve conditions like hemifacial spasms.

The first line of treatment for hemifacial spasm in TCM is herbal therapy. Qian Zheng San (牽正散) is commonly used for this condition.

The remedy’s primary ingredient, the giant Typhonium rhizome (bai fu zi, 白附子), enters the stomach meridian (yang ming, 阳明) and warms the anterior parts of the body such as the face and abdomen.

You can also brew calming herbs like rosebuds (mei gui hua, 玫瑰花) and longan (long yan rou, 龙眼肉) in a tea for added benefits.

Acupuncture and acupressure

The successful TCM treatment of hemifacial spasm includes the use of acupuncture and acupressure. Studies have shown that the following acupoints are effective:

He gu (LI4, 合谷)

Yu ji (LU10, 鱼际)
Quan liao (SI18, 颧髎)
Xia guan (ST7, 下关)
Yin tang (EXHN3, 印堂)
Bai hui (GV20, 百会)

Er shen men (HT7, 神门)
Feng chi (GB20, 风池)
Nei guan (PC6, 内关)
Tai chong (LR3, 太沖)

An illustration of the he gu or LI4 acupoint as one of the acupressure points to relieve a runny nose — He gu is useful in helping rebalance the flow of qi and expel lingWind, providing relief from allergy symptoms.

yu ji — On the radial aspect of the 1st metacarpal at the midpoint of the bone at the junction of the red and white skin.

quan liao — Directly below the outer corner of the eye in a depression on the lower border of the cheekbone.

Xia guan — At the lower border of the cheekbone, in the depression anterior to the condyloid process of the lower jawbone.

An illustration of yin tang acupressure point located between the eyebrows — Stimulating yin tang after a day full of work can help relieve headaches.

Bai Hui — Bai hui is located at the uppermost point on the human body, in the centre of the top of the head.

located on the lateral third of the triangular fossa at the branch between the superior crus and the inferior antihelix,

An illustration of feng chi as one of the acupressure points to heal symptoms of cold — Feng chi is located at the back of the neck, where you can feel a depression on the base of the hairline as shown above.

nei guan — Nei guan is located on the front of the forearm, 3-fingers breadth above the transverse crease of the wrist. It restores and enhances the heart’s function for improved qi and blood circulation within the meridians.

An illustration of tai chong acupressure point for teeth health in pregnant women. — Located about two finger widths below the spot where the skin of your big toe and second toe join together.

For maintenance, you can perform acupressure on feng chi, nei guan and tai chong acupoints. Gua sha and tuina massage can also be used as supplementary therapies.

To prevent the onset or recurrence of the condition, try to maintain a healthy lifestyle with a balanced diet, exercise, and stress management. Stop smoking and limit your alcohol intake. It’s also a good idea to avoid prolonged exposure to cold air or water and eating too many cold foods.

Wondering if you might have hemifacial spasms? Save this article, monitor symptoms, and consult your doctor immediately.