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What are facial pains and spasm?

Pains and spasms of the facial muscles are typically caused by injuries to either the facial nerve or the trigeminal nerve. This is commonly due to pressure being exerted on the nerves by blood vessels. Sometimes an exact cause cannot be determined.

What are the different types of facial pains and spasms?

There are many different causes of facial pain and spasm, some of which can be treated surgically. Dr. Vasudevan, brain and spine surgeon in St. Louis, treats many of these conditions including:

  • Trigeminal neuralgia (TN), or tic douloureux: a neurological condition characterized by pain of the face arising from the trigeminal nerve. TN in the majority of cases is caused by abnormal positioning of an artery near the brainstem. This loop presses against the trigeminal nerve with each beat of the heart and this repeated process can eventually wear down the nerve’s insulating barriers and cause irritation and pain.

  • Hemifacial spasm: is a neuromuscular disease where spasms of one half of the face occurs. In some cases, this may be caused by pressure from an artery on the facial nerve near the brainstem. This pressure or compression of the nerve results in the tics or muscle spasms seen in this disorder.

What are the signs and symptoms of facial pains and spasms?

Symptoms of trigeminal neuralgia can be hard to discern from other sources of pain. What follows below are some distinctive symptoms of trigeminal neuralgia or hemifacial spasm:

  • Intensely sharp, stabbing, or shock-like pain of the face

  • Oftentimes (but not always) pain is concentrated on one side of the face

  • Triggered pain from touching the face, brushing of the teeth, chewing, speaking, or other normal activities

An initial symptom of hemifacial spasms is twitching of the eye or eyelid that can vary in intensity. This twitching can spread to other muscles on the same side of the face.

How do you treat trigeminal neuralgia and hemifacial spasm?

Surgical alleviation of pain is often the next course of action for patients with trigeminal neuralgia who have already tried to medicate the condition. Your personal treatment plan will be discussed on an individual basis. What is listed below is a series of surgical procedures that may be effective at treating TN:

  • Microvascular decompression (MVD): begins with making a small window into the skull and then identifying and moving the compressing blood vessel that is putting pressure on the trigeminal or facial nerve.

  • Stereotactic radiosurgery (SRS): a beam of radiation will focus on the area where the trigeminal nerve departs the brain stem, slowly forming a lesion on the nerve that disrupts sensory signals on their way to the brain.

Patients in St. Louis can also try medication to treat hemifacial spasms. When medication is not helpful in alleviating their condition then patients typically undergo injections with botulinum toxin or surgery.

Why our practice?

Trigeminal neuralgia and hemifacial spasm can be debilitating for many patients and Dr. Vasudevan, brain surgeon in St. Louis, understands these issues. Our treatments are state of the art when it comes to hemifacial spasms and trigeminal neuralgia. If you or a loved one has been diagnosed with a facial pain or spasm condition, we can help. Contact us today to schedule an appointment.

Facial Pain & Spasms Neurosurgeon in St. Louis - Kumar Vasudevan, MD

Facial Pain & Spasm


Applying our brain surgery expertise to the treatment of trigeminal neuralgia, hemifacial spasm, and other facial pain disorders.


​We are here to help you make sense of your options and get you the care that you need.

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