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Hemifacial spasm is a neurological disorder that manifests as involuntary muscle spasms on one side of the face. In most cases, a blood vessel contacting or pulsating against a facial nerve is the cause of hemifacial spasm. However, tumors or injuries to the facial nerve also can potentially cause this condition.
While hemifacial spasm has no permanent cure, individuals often experience relief from symptoms through the use of medication, injections, or surgical interventions. You can also alleviate symptoms by ensuring you get ample rest and minimizing stress.
Symptoms
The initial symptom of hemifacial spasm is the intermittent eye twitching, which is generally not indicative of a health issue. These contractions are just movements of the muscles. In individuals with hemifacial spasm, eye twitching can advance to affect other areas of the face. It first occur intermittently, but over the course of months or years, they may become constant, especially during periods of stress or fatigue.
Hemifacial spasms can occasionally affect both sides of the face. But the twitching never occurs simultaneously on both sides of the face. Typical symptoms of hemifacial spasm involve involuntary muscle jerking primarily affecting the face.
- Not controllable
- No pain
- Restricted to one side of the face
Causes
Hemifacial spasm arises due to the compression of facial nerves. Typically, muscle twitches occur when a blood vessel compresses a facial nerve.
Other factors such as facial nerve injuries, or tumors can also contribute to its development. Hemifacial spasm may also be triggered by activities like moving facial muscles, experiencing anxiety, stress, or fatigue.
In some cases, the facial twitches have no apparent cause, leading to identifying the condition as idiopathic hemifacial spasm.
Diagnosis
The diagnosis of hemifacial spasm usually requires a thorough evaluation process. It may require a physical examination, and in some cases, certain tests can be employed to identify the underlying cause.
Tests that may be ordered include:
- MRI scan: This is a non-invasive procedure that utilizes radio waves and magnetic fields to generate comprehensive images of the internal structures within the body.
- Magnetic resonance angiogram: This is a specific type of MRI that involves injecting a contrast dye into a blood vessel to determine if it is in contact with the facial nerve.
These tests are often reserved for individuals with atypical symptoms or those preparing for surgery. Generally, imaging tests are not necessary for every case of hemifacial spasm.
Treatment
Treatment is tailored based on the severity of the hemifacial spasm symptoms. Options may include:
- Oral medication: For mild symptoms, carbamazepine, clonazepam, or baclofen might be recommended as the initial treatment. These medications work by interrupting the electrical signals in the brain that lead to spasms.
- Botulinum injections: In most cases, this can effectively manage symptoms. The procedure needs to be repeated every few months. Botox is administered via injection into the affected muscles temporarily inhibits muscle movement.
- Surgery: Various surgical approaches can alleviate hemifacial spasm, such as:
- Radiofrequency thermocoagulation: This involve surgically destroying parts of the facial nerve using heat and radio waves.
- Decompression: This is often successful in relieving hemifacial spasm. In this procedure, a small part of the skull is lifted, and the healthcare provider locates the blood vessel causing the pressure on the facial nerve. The blood vessel exerting pressure on the facial nerve is identified and a spongelike material is placed between them to alleviate pressure.
