Column May 2, 2025
Hemifacial Spasm — When the Lower Eyelid or Mouth Twitches
Hyo-seop Kim
Chief Director
Table of Contents
The lower eyelid keeps twitching
Hemifacial spasm is a condition in which the muscles on one side of the face — especially around the lower eyelid and the mouth — repeatedly contract involuntarily. It often starts as eyelid twitching and gradually spreads to the cheek and the area around the mouth.
Korean medicine diagnosis: blood deficiency generating wind (血虛生風)
- Blood deficiency (血虛): Insufficient blood fails to nourish muscles, leading to spasms — common in women and the elderly
- Wind (風): Internal wind generated by blood deficiency affects the face — twitching and contractions
- Internal stirring of liver wind (肝風內動): Stress and fatigue convert liver yang into wind → worsens symptoms
Treatment
- Modified Siwu-tang plus Yigan-san: A combined formula that nourishes blood while calming liver wind
- Acupuncture: Sizhukong (TE23), Sibai (ST2), Jiache (ST6), and Yangbai (GB14) relax facial muscle tension; Taichong (LR3) suppresses liver wind
- Pharmacopuncture: Applied to the most spasmodic areas to relieve muscle hypertonicity
Botox and Korean medicine
In conventional medicine, Botox injections suppress spasms, but the procedure must be repeated every 3–6 months. By improving the underlying constitution (blood deficiency) through Korean medicine, the intensity and frequency of spasms can be reduced and dependence on Botox lowered.