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Hemifacial spasm is a neuromuscular disorder that causes involuntary twitching on one side of the face. It can be caused by facial trauma, pinched nerves, cancer, or underlying diseases. Treatment includes muscle relaxants, botulinum toxin injections, or surgery. It is more common in senior citizens and those who have suffered injuries to the face, head, or brainstem.
A hemifacial spasm is an uncontrollable twitching or twitching of the muscles on one side of a person’s face. It is considered a neuromuscular disorder that can result from facial trauma, pinched nerves, cancer, or an underlying disease such as multiple sclerosis. A hemifacial spasm typically begins in an isolated area, such as the eyelid, and spreads to one side of the face over time if left untreated. Doctors may prescribe muscle relaxants, inject botulinum toxin into muscles, or perform invasive surgery to relieve pressure on facial nerves. Individuals receiving treatment are usually relieved of some or all of their symptoms immediately, although many patients require ongoing treatment to suppress recurring spasms.
Most cases of hemifacial spasms occur when blood vessels are pressed against facial nerves. This can both affect the function of a nerve and cause it to contract involuntarily from time to time. A hemifacial spasm can happen to anyone, although they are more common in senior citizens and those who have suffered injuries to the face, head, or brainstem. Occasionally, a tumor can compress the facial nerve and lead to spasms. Individuals with certain neurological disorders such as multiple sclerosis are also prone to twitching and tics that may or may not be limited to the face.
A hemifacial spasm generally begins in a single muscle, most often the eyelid. It can cause irregular contractions and force the eye to close unpredictably. Over time, it can spread across the face, eventually affecting the muscles that control mouth movement. Many people who experience progressive hemifacial spasms experience frequent tics that significantly impair speech and vision.
It is usually easy for a trained doctor to recognize a hemifacial spasm, although it can be more difficult to diagnose the cause. A doctor can use an MRI machine to check for tumors or other visible abnormalities, and an electromyogram to discover other neurological problems. An EMG is a small precision needle that is inserted into a facial muscle to record electrical activity and identify irregular spasms.
Treatment for a recurring hemifacial spasm can take the form of prescription oral medications, botulinum toxin injections, or surgery. Individuals with mild or infrequent spasms may benefit from taking muscle relaxants, although doctors caution against long-term use of these drugs which can be addictive. Most people receive local injections of botulinum toxin to effectively paralyze their muscles for up to eight months. If medications and injections are ineffective or the spasms are severely debilitating, a patient may need to undergo a surgical procedure known as microvascular decompression to displace blood vessels and relieve pressure on the facial nerve.
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