Hemifacial Spasm: Overview of symptoms, causes and treatment

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Hemifacial Spasm (HFS)
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Hemifacial Spasm (HFS)

• 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.

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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.

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Causes of Hemifacial Spasm (HFS)
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• 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.

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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.

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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. 

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Treatments
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• 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.

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Treatments
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• 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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