Hemifacial spasm sufferers experience brief, recurring episodes of facial twitching. When people experience eye spasms only, they may have a condition called blepharospasm. Hemifacial spasm is a condition usually caused by a blood vessel compressing the root of the hemifacial nerve inside the brain. More rarely, hemifacial spasm sufferers have a tumor pressing on the hemifacial nerve, so an MRI of the brain may be needed to aid in diagnosis.
Hemifacial spasm is a common condition, and many people live with the condition and do not seek medical treatment. If the facial twitching or eye spasms become difficult to live with, there are several nonsurgical treatment options available.
Hemifacial spasm relief can occur with the use of anti-seizure medications such as Neurontin, Lyrica, Trileptal, or Tegretol. Botox injections also provide excellent relief from the facial twitching for several months and may be repeated if symptoms recur. If neither the medication nor the botox injections are satisfactory, we may consider a surgical procedure.
Microvascular decompression surgery is performed under general anesthesia. We make a small incision behind the ear on the affected side, remove some bone, and, using a microscope, move the blood vessel away from the nerve and insert a small sponge. A microvascular decompression takes about two hours to complete, and patients usually remain in the hospital for about two days.
Microvascular decompression is a low risk operation that works most of the time. Most patients experience immediate relief, though some find that their symptoms improve over the course of several weeks.
In summary, although hemifacial spasm is a benign condition, it can be very bothersome for people. Effective treatments include medicines, botox injections, and microvascular decompression surgery.