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Idiopathic Hemifacial Spasm constitutes a severe disability both from a cosmetic and psychological point of view and functionally for the daily life. Until recently this peculiar disease had remained enigmatous and was resistant to any kinds of treatments. Over the last two decades important advances have been made in the comprehension of its mechanisms and the efficacy of its treatment. Botulinic toxin revealed to be helpful although its effects are most often transient. Microvascular decompression – suppressing the neuro-vascular conflict almost constantly found at the root exit zone of the facial nerve from the brain stem – has been recognized as the curative treatment of this disease. A wide range of specialists, namely neurologists, ophthalmologists, ENT-surgeons, clinical neurophysiologists, neuroradiologists and of course neurosurgeons are involved in the diagnosis and the management of Hemifacial Spasm and will be interested in this multidisciplinary review of the topic.
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