HEMIFACIAL SPASM

HEMIFACIAL SPASM

What is hemifacial spasm?

Hemifacial spasm (HFS) refers to sudden episodic involuntary contractions of muscles on one side of the face.

                                                                                   (Swedish)

Who suffer from hemifacial spasm?

Hemifacial spasm occurs in people all over the world. It occurs more commonly in people aged 40-60 years. It affects both men and women, however, slightly more common in women.

What causes hemifacial spasm?

1.     In most people, there is no specific cause for hemifacial spasm, when it is referred to as idiopathic.

2.     In some people, there is compression of facial nerve (that supplies facial muscles) by a blood vessel.

3.     In some others, the compression could be due to tumors, aneurysms (abnormal balloon-like dilatation of the vessel wall), etc.

4.     Medical problems of brain such as infarct (blood clot in brain) or multiple sclerosis can also cause HFS.

What investigations are usually needed?

A detailed clinical examination needs to be performed by neurologist. This would confirm the diagnosis. The diagnosis is based on clinical examination and no test is needed for that. However, MRI with MR Angiogram brain is needed to exclude secondary causes (as listed in points 2-4 above).

How is hemifacial spasm treated?

1.     Botulinum toxin (botox) is the treatment of choice. Botox injections are given in the affected muscles. The benefit is seen within a few days and the effect may last upto 6 months.

2.     Those who refuse botox or cannot afford it can be treated with medications such as carbamazepine, clonazepam or baclofen tablets.

3.     Those who do not respond to botox or medicines can be treated with microvascular decompression (MVD) surgery.

Can there be a serious complication due to hemifacial spasm?

If all secondary causes have been excluded with MRI of brain, we do not expect any serious complications. However, frequent closure of eyes can be a hindrance for safe driving. Moreover, it may lead to awkward situations, especially in front of people of opposite gender.

What is the long-term outcome of hemifacial spasm?

Both botox and MVD surgery are effective and safe treatments, leading to excellent long-term outcome.

DR SUDHIR KUMAR MD DM

CONSULTANT NEUROLOGIST

Apollo Hospitals, Hyderabad

drsudhirkumar@yahoo.com

https://www.facebook.com/bestneurologist/

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