What is Hemifacial Spasm?
Hemifacial spasm is a neuromuscular
disorder characterized by frequent involuntary contractions (spasms) of
the muscles on one side (hemi-) of the face (facial). The disorder
occurs in both men and women, although it more frequently affects middle-aged or
elderly women. It is much more common in the Asian population. The first
symptom is usually an intermittent twitching of the eyelid muscle that can lead
to forced closure of the eye. The spasm may then gradually spread to involve the
muscles of the lower face, which may cause the mouth to be pulled to one side.
Eventually the spasms involve all of the muscles on one side of the face almost
continuously. The condition may be caused by a facial nerve injury, or a tumor,
or it may have no apparent cause. Rarely, doctors see individuals with spasm on
both sides of the face. Most often hemifacial spasm is caused by a blood vessel
pressing on the facial nerve at the place where it exits the brainstem.
Is there any treatment?
Surgical treatment in the form of microvascular decompression, which relieves
pressure on the facial nerve, will relieve hemifacial spasm in many cases. This
intervention has significant potential side-effects, so risks and benefits have
to be carefully balanced. Other treatments include injections of botulinum
toxin into the affected areas, which is the most effective therapy and the only
one used in most cases. Drug therapy is generally not effective.
What is the prognosis?
The prognosis for an individual with
hemifacial spasm depends on the treatment and their response. Some individuals
will become relatively free from symptoms with injection therapy. Some may
require surgery. In most cases, a balance can be achieved, with tolerable
residual symptoms.
What research is being done?
The National Institute of Neurological
Disorders and Stroke (NINDS) conducts and supports research related to
hemifacial spams through grants to major research institutions across the
country. Much of this research focuses on better ways to prevent, treat, and
ultimately cure neurological disorders, such as hemifacial spasm
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