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Hemifacial Spasm (HFS)
Posted on Jun 22, 2016
Hemifacial Spasm (HFS) is a neuromuscular disorder, generally observed in middle-aged men and women, and it inflicts the muscles of one side of the face. These muscles undergo frequent, involuntary twitching or contractions. In this disorder, the seventh cranial nerve is constricted by blood vessels, which results in the varying degrees of facial spasms. The treatment encompasses the use of oral medicines, injections, and surgery.

Causes of Hemifacial Spasm (HFS)

A common cause is injury to the facial nerves, which serve as the carriers of signals from the brain to the facial muscles. Any damage to these nerves may hinder the communication of information, resulting in twitching or compression. Such damage may also occur due to the development of a tumour.

In some cases, a dislocated blood vessel may exert pressure on the facial nerve, thereby disrupting the normal neural communication. In the brain-stem, the facial nerve originates at a point which is known as the anterior inferior cerebellar artery. This artery may cause a build-up of pressure on the facial nerve, causing it to misfire, eventually resulting in the abnormal contraction of the facial muscles.

Another probable cause of hemifacial spasm is a condition known as Bell's palsy. Here, the nerve which is responsible for keeping a control on the facial muscles gets inflamed.
Symptoms:
In the early stages, the affected person may experience such contractions around the eye. Over time, the condition tends to spread to the lower facial muscles, and the mouth seems to be pulled to one side. This happens in most of the cases.

In some patients, the symptoms start near the chin, and progress in an upward direction. Generally, the twitching is not painful. However, the unsightly facial expression may become a source of embarrassment in public.
Treatments:
Oral medication, injections, and surgery are the three major treatment options for this condition. Patients are kept under routine monitoring, and have to undergo blood tests.

Oral medication comprises anti-convulsant drugs like carbamazepine or phenytoin. These drugs help to suppress the rapid and excessive firing of neurons, and control the twitching. As the facial muscles undergo extreme amount of pressure and discomfort due to the frequent episodes of twitching or contraction, muscle relaxants may be recommended. The common examples include baclofen, diazepam, and clonazepam.

Injections for the treatment of hemifacial spasm include botox injections, which cause temporary muscle paralysis. A neurotransmitter known as acetylcholine carries the electrical messages transmitted to the muscles. Botox injections block such messages, and help in reducing or preventing the contraction of muscles. The effect of such injections begins in three days, and may persist for a period of about three months. Side effects like facial weakness, eye irritation, and droopy eyelids may be experienced.

Cases which show no improvement despite the use of medications and botox injections are dealt with the help of a surgery known as microvascular decompression. About 90% of patients have been observed to be completely cured, after about two months.

Try to avoid stress, emotional strain, fatigue, bright lights, excessive reading, etc., because factors like these are known to aggravate the symptoms of this condition.
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