HFS is most commonly secondary to compression of the facial nerve near the exit of this nerve from the brainstem. This compression is usually by a small blood vessel near the base of the brain. Less commonly, brain tumors, aneurysms or trauma can result in compression of this nerve. If atypical features are present, such as numbness of the affected side of the face or hearing loss, an MRI may be useful as part of the evaluation. With regards to medications, although a number have been used for this condition, they are rarely helpful.
Surgery is available to relieve the compression of the seventh nerve.
This procedure, in a small number of cases, can result in facial weakness, deafness or stroke. Thus, many physicians prefer the use of botulinum toxin injections as the initial treatment. Using relatively low doses, the excess contractions are reduced without creating facial weakness. The procedure is usually well tolerated with potential side effects of eyelid drooping or facial weakness but these are typically mild and transient. A Report of Five Cases and a Literature Review.