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Hemifacial Spasms - How They Can Be Treated?

M.Ch - Neuro Surgery, DNB (Orthopedics)
Neurosurgeon, Hyderabad  •  26 years experience
Hemifacial Spasms - How They Can Be Treated?

A Hemifacial spasm is a disorder of the nervous system that causes one side of the face to twitch involuntarily. This may be caused by the compression or irritation of facial nerves. This is most commonly caused by a blood vessel that puts pressure on a facial nerve. In many cases, there is no apparent cause of a hemifacial spasm. In other cases, it can be triggered by an injury to a facial nerve or a tumor.

One of the most characteristic symptoms of this condition is involuntary twitching of the facial muscles. This typically begins around the eyes and can lead to forced closure of the eye. Gradually, these spasms spread to the lower part of the face and may turn continuous or affect all the facial muscles on one side of the face. These spams may worsen when the person is stressed or tired. Pain is usually not a symptom of this condition.
Hemifacial spasms can be treated in a few different ways. These include:

  1. Botulinum Toxin Injection: This is the most common form of treatment for this condition. This involves injecting small amounts of botulinum toxin into the patient’s face. The area around the eye is the primary target for such treatment. As a result of these injections, the muscles in the face are temporarily weakened and spasms are relieved. The effects of this injection can last for 3 to 6 months. Some of the side effects of this form of treatment include weakness, ptosis and facial asymmetry. However, these effects are usually temporary.
  2. Pharmacologic Therapy: In cases where spasms are infrequent and mild, medication may be used as treatment. It is also often prescribed to people who cannot be treated for this condition with botulinum toxin injections. Medication may also be prescribed to patients with early idiopathic hemifacial spasms or non-compressive lesions. This form of treatment is usually successful in early of mild cases of hemifacial spasms. However, over time, the effects of these medications can attenuate and more aggressive treatment may be required.
  3. Surgical Decompression: This form of treatment can have excellent results. It is often recommended in cases where the other two forms of treatment are unsuccessful. The most common type of surgical procedure used to address this condition is known as microvascular decompression. Another type of surgery that can be used is called the posterior fossa exploration. In rare cases, a Myectomy may be prescribed.

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