What is Hemifacial Spasm?
Hemifacial spasm is a unilateral (one side of the face) involuntary burst or spasm of the muscles of the face. It usually begins by twitching involving the muscles around the eye (orbicularis oculi muscles). Typical twitching of the eyelids usually resolves in a few weeks. The contractions of hemifacial spasm usually progresses occurring more often and spread across the face including the mouth, cheek, neck and on occasion the forehead.
Other Symptoms of Hemifacial Spasm
Hemifacial spasm is usually not painful but can be painful in some cases.
Foreign body sensation in the eye is common.
Hemifacial spasm may be exacerbated by stress or fatigue.
There may be evidence of aberrant regeneration.
What Causes Hemifacial Spasm?
Hemifacial spasm is felt to be caused by pressure or irritation of the seventh (facial nerve) where it exits the brainstem. In very rare cases less than one percent it can be caused by lesions pressing on the seventh nerve, such as tumors, aneurysms, and other vascular lesions.
Other entities characterized by abnormal facial movements include facial Myokymia, essential blepharospasm, Meige syndrome, and Tourette’s syndrome.
How is Hemifacial Spasm Treated?
Medicines used for hemifacial spasm include Artane, Klonopin, Ativan, and Lioresal. These have had limited success.
Botox® injections are the mainstay of treatment for hemifacial spasm. The injections are placed in the area where the spasms are located. The injections last approximately three to four months.
Surgical Treatment for Hemifacial Spasm
Microvascular decompression of the nerve and blood vessel can be performed.
Isolation of the facial nerve and cutting the nerves supplying the area of spasm is a method. This treatment is not used very often anymore.
Tests for Hemifacial Spasm
A MRI should be performed on people when first diagnosed with hemifacial spasm as there is a small probability of a lesion in the midbrain.