Treatment of hemifacial spasm in Turkey

Hemifacial spasm

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
Illustration of the case of hemifacial spasm, corresponding to a picture of a normal face
An image showing a hemifacial spasm

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:

Drug therapy

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.

Botox injection, which is used to treat hemifacial spasm in Turkey
Botox

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.

One of the causes of hemifacial spasm is the blood vessel pressing on the facial nerve, and the treatment in this case is through a surgical intervention and the placement of a metal plate between the vessel and the nerve very carefully.
The picture shows how to treat hemifacial spasm caused by abnormal placement of a blood vessel

Surgical results

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.

Surgical risks

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.

Sources:

  1. Mayoclinic
  2. Healthline
  3. cleveland clinic

Common Questions

Not enough studies have been conducted on the effectiveness of herbs in treating facial spasm. There are some herbs that are believed to be useful in relieving the symptoms of the disease, such as Libyan flower oil, which is applied and massaged around the face. However, consulting a doctor remains the best option for treating facial spasms.

Hemifacial spasm does not usually cause a danger to the patient, but it might causes uncomfortable symptoms for the patient.

In most cases, hemifacial spasm is treated with Botox injections to relieve facial spasms, and some medications can be used to relieve symptoms, and in severe cases, surgery is required.

There are some factors that cause hemifacial spasms, such as anxiety, reading or speaking.

In most cases the cause of hemifacial spasm is due to a blood vessel that presses on the facial nerve, and the cause can be a traumatic injury to the facial nerve or a tumor pressing on the nerve.

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