Hemifacial spasm causes disturbing symptoms represented by involuntary movements of the facial muscles on one side of the face. Learn more about hemifacial spasm treatment in Turkey.
What is hemifacial spasm?
Hemifacial spasm is a neuromuscular disorder characterized by involuntary contractions (twitches) of the muscles on one side of the face.
Eyelid twitching is the first symptom of hemifacial spasm. Rapid, frequent eye closure is also seen. The spasm may spread over time to affect the muscles of the cheeks around the mouth.
This involuntary movement takes place due to stimulating the facial nerve. When a person wants to close his eyes, this nerve is alerted and sends the nerve impulse responsible for the movement.
Hemifacial spasm is seen more commonly in women, and symptoms often appear in their 50s or 60s.
Causes of hemifacial spasm
Hemifacial spasm occurs due to frequent involuntary stimulation of the facial nerve. Repeated stimulation of the facial nerve may occur for one of the following reasons:
- Abnormal blood vessel pressing on the facial nerve
- Traumatic injury to the nerve
- A compressive mass such as a tumor pressing on the facial nerve
- Unknown reasons
Symptoms of hemifacial spasm
Hemifacial spasm causes disturbing symptoms to the patient, causing him social problems because of these contractions. Symptoms appear as follows:
- The first symptom is recurrent eye twitching on one side
- over time, spasm is seen in other facial muscles (the cheeks and around the mouth).
- Spasms during sleep which wake the patient up
- Spasms are painless
- Some suffer from hearing impairment and buzzing in the ears
- In more advanced cases, a spasm may occur in the lower jaw, and the jaw turns to one side
- Facial spasms become sever if the patient is tired, stressed, or agitated and crying
Diagnosis of hemifacial spasm
Hemifacial spasm is diagnosed when the doctor notices involuntary movements on one side of the patient's face, so the diagnosis depends mainly on the clinical examination and signs.
The doctor may order an MRI to rule out other causes, such as tumors, structural abnormalities, or diseases such as multiple sclerosis.
The doctor may inject a contrast material to see the abnormal blood vessel pressing on the facial nerve.
Hemifacial spasm treatment
Treatment methods vary according to the severity of symptoms, including:
In the case of mild symptoms, anticonvulsant drugs (carbamazepine, clonazepam) can be used. These drugs work by blocking nerve signals that cause spasms.
botulinum injection (Botox)
It is often considered the most effective treatment, low doses of botulinum are injected around the muscles affected by the spasms. Botulinum works by impairing the movement of the injected muscles and preventing spasms from happening.
Most patients need to re-inject Botox once every 3 to 6 months, and the need for re-injection varies according to the severity of the spasm and the response to treatment.
Side effects of botulinum injection (Botox)
Botulinum injection may be associated with muscle disturbances, fatigue, dizziness, fever, a skin rash, dry mouth, and in rare cases serious symptoms may occur when overdosing.
Microvascular decompression surgery
If there are blood vessels pressing on the facial nerve, surgery can be used.
The neurosurgeon makes an opening in the skull and exposes the facial nerve. The blood vessels in contact with the nerve are identified, then the surgeon places a small metal plate separating the blood vessel from the facial nerve.
This surgery often carries excellent results for the patient, and most patients are discharged from the hospital two to three days after the surgery.
if the surgery was performed efficiently and by an experienced surgeon, the symptoms will disappear immediately right after the surgery.
There is no risk-free surgical procedure. Some patients reported temporary weakness in the facial muscles after surgery, and rare cases of hearing impairment were recorded.
Is Hemifacial spasm a common disease?
In fact, Hemifacial spasm is a rare disease, as 11 out of 100,000 people around the world have it, and it occurs more often in women, with a ratio of 2:1.
It is seen more commonly in Asian and Mediterranean countries, and some studies indicated that the incidence of hemifacial spasm is more on the left side than on the right side of the face.
the spasm occurs on one side of the face most of the time, but in very rare cases, the facial spasm may occur on both sides.
Prevention of hemifacial spasm
There are no ways to prevent this problem, but facial spasms can be improved by avoiding factors that contribute to spasms, such as stress, anxiety, fatigue.
According to studies, Facial massage using a device may help improve the patient’s condition, in addition to relaxing, drinking coffee, and taking an appropriate amount of vitamin D and magnesium to help relieve symptoms.
conditions similar to hemifacial spasm
There are other diseases that present with symptoms somewhat similar to facial spasm, such as:
- facial nerve paralysis Or better known as Bell's nerve palsy
- Tumors affecting the head and neck, benign or malignant
- Oculomotor neuritis (damage to the third nerve)
- A disease known as blepharospasm, it is important to distinguish between the two diseases as blepharospasm usually affects only small muscles around the eyelids while hemifacial spasm can affect several muscles in the face.