Hemifacial spasm
Hemifacial spasm is a contraction of the muscles on one side of the face. It is not painful but it is very uncomfortable, so it is essential to make a diagnosis that allows choosing the appropriate treatment.
Hemifacial spasm
Hemifacial spasm is a contraction of the muscles on one side of the face. It is not painful but it is very uncomfortable, so it is essential to make a diagnosis that allows choosing the appropriate treatment.
What is hemifacial spasm?
El hemifacial spasm is a nervous system disorder that causes a involuntary and painless contraction of facial muscles, only on one side of the face.
Causes
In most cases, hemifacial spasm is due to a blood vessel touches a facial nerve.
Other possible causes is a facial nerve injury or tumor although there are also cases in which the cause cannot be identified of facial spasm.
Symptoms of hemifacial spasm
The main symptom of hemifacial spasm is that the muscles on one side of the face they contract involuntarily.
Contractions start as a tremor in the left or right eye that radiates towards the surrounding areas, also affecting the cheek and mouth.
At first the contractions are intermittent, but afterwards they are almost constant.
Hemifacial spasms are painless, but the person may feel uncomfortable by its appearance, since the expression of the face can change.
Your symptoms usually disappear during rest hours, although there are patients who also experience movements in the eyelids and tearing during sleep.
Diagnosis
The ophthalmologist performs a Physical exam the patient, looking for signs of hemifacial spasm.
Sometimes it is necessary to make a diagnostic imaging analysis to find the cause of the disease and prescribe the most appropriate treatment.
At magnetic resonance imaging (MRI) Radio waves and powerful images that create detailed images of the head are used to detect the cause of hemifacial spasms.
Sometimes the ophthalmologist has to inject a contrast dye (magnetic resonance angiogram) to check if any abnormal blood vessels are irritating the facial nerve.
Treatment of hemifacial spasm
All the options available to treat involuntary blinking that causes hemifacial spasm are the following:
Botulinum toxin
Consists in inject four or five doses of botulinum toxin into the affected muscles, paralyzing them temporarily. It is not a definitive solution, since should be repeated every few months.
This treatment is outpatient, which means that the patient is discharged on the day and does not require anesthesia.
The only care that the patient should follow after treatment with butolinium toxin is to do not touch your face or rub your eyes for two hours, to prevent the toxin from spreading incorrectly.
There may be adverse consequences that disappear in a few days or weeks at the most, such as a drooping eyelid (known as ptosis) or deviation of the corner of the lips.
Injection of botulinum toxin is the most widespread treatment to treat hemifacial spasms.
Other medications
Some medications, such as anticonvulsants, relieve spasms in the eyelid of patients.
The same drugs used in the treatment of trigeminal neuralgia can be used: gabapentin, carbamazepine, baclofen, phenytoin y cyclic antidepressants.
Microvascular decompression surgery
When drug treatment is not sufficient to relieve hemifacial spasm, a surgical intervention call vascular decompression. This operation is carried out with the aim of separate an artery that is pressing on a nerve.
The surgeon makes a hole in the skull and opens the membrane that surrounds the brain (dura) to expose the facial nerve as it exits the brain stem.
Once the blood vessel that is irritating the facial nerve is located, a spongy textured material is placed between the nerve and the blood vessel, thus eliminating pressure on the nerve.
This operation is carried out with general anesthesia. The risk of side effects is low, and the results are almost always satisfactory.
Variation of hemifacial spasm
There is a variant of hemifacial spasm:
Blepharospasm
It is an abnormality in the function of the eyelids that occurs in the brain, and that entails a constant contraction of the muscles of both eyelids.
It begins as itching, more frequent than normal blinking that increases excessively, dry or tired eyes, and discomfort when watching television or being exposed to bright light.
There are severe cases in which patients are virtually unable to see since they cannot move their eyes voluntarily.
El blepharospasm appears between forty and seventy years. It mainly affects women and its cause is unknown.
