Treated conditions

Facial Nerve Hemispasm

Hemifacial spasm involves unilateral, involuntary, intermittent facial muscle contractions. The facial nerve controls facial expression muscles (forehead, eyes, cheeks, neck). The primary cause is pulsations from a blood vessel contacting the facial nerve at its brainstem emergence.

Symptoms

Symptoms include progressive involuntary facial muscle contractions, often starting around the eyes and spreading. Stress, fatigue, driving, bright lights, TV watching, and reading can exacerbate the condition.

Diagnosis

Brain MRI is indicated to exclude space-occupying lesions and document possible neurovascular conflict.

Treatment

Conservative treatment

Includes oral medication (carbamazepine, phenytoin, baclofen, clonazepam) with limited efficacy and side effects like mental confusion and sedation.

Botulinum Toxin Injections

The most effective treatment involves injecting botulinum toxin into the affected muscles, providing relief for 3-6 months, with the procedure requiring repetition. Side effects are rare and temporary.

Surgical Treatment

Microvascular decompression is a surgical method involving separation of the blood vessel from the facial nerve with a foam pad, achieving symptom resolution in over 85% of cases.