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.