Hemifacial Spasm
Hemifacial Spasm
Definition
Causes
- A blood vessel pressing on the facial nerve (most frequent cause)
- Tumor
- Facial nerve injury
- Bony or other abnormalities that compress the nerve
| Muscles of the Face |
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Risk Factors
- Being a middle-aged or elderly woman
- Hypertension
Symptoms
- Intermittent twitching of the eyelid muscle
- Forced closure of the eye
- Spasms of the muscles of the lower face
- Mouth pulled to one side
- Continuous spasms involving all the muscles on one side of the face
Diagnosis
- Electromyography (EMG) —a test that measures and records electrical activity generated in muscle at rest and in response to muscle contraction
- Magnetic resonance imaging (MRI) —a test that uses magnetic waves to make pictures of structures inside the head
- Computed tomography (CT) scan —a type of x-ray that uses a computer to make pictures of structures inside the head
- Angiography —an x-ray exam of the blood vessels when they are filled with a contrast material
Treatment
Medication
- Carbamazepine
—This
is often used initially, with improvement in symptoms in up to half of patients who are treated.
- According to the Food and Drug Administration (FDA), patients of Asian ancestry who have a certain gene, called HLA-B*1502, and take carbamazepine are at risk for dangerous or even fatal skin reactions. If you are of Asian descent, the FDA recommends that you get tested for this gene before taking carbamazepine. If you have been taking this medicine for a few months with no skin reactions, then you are at low risk of developing these reactions. Talk to your doctor before stopping this medicine.
- Gabapentin and baclofen —These may also be beneficial for treating hemifacial spasm in some patients.
Botulinum Toxin Injections
Surgery
RESOURCES
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/
National Organization for Rare Disorders http://www.rarediseases.org/
CANADIAN RESOURCES
Canadian Movement Disorder Group http://www.cmdg.org/
Hemifacial Spasm Association http://www.hfs-assn.org/
References
Alexander GE, Moses H. Carbamazepine for hemifacial spasm. Neurology. 1982;32:286-287.
Defazio G, Martino D, Aniello MS, et al. Influence of age on the association between primary hemifacial spasm and arterial hypertension. J Neurol Neurosurg Psychiatry. 2003;74:979-981.
Digre K, Corbett JJ. Hemifacial spasm: differential diagnosis, mechanism, and treatment. Adv Neurol. 1988;49:151-176.
Ehni G, Woltman HW. Hemifacial spasm. Arch Neurol Psychiatry. 1945;53:205-211.
Hemifacial spasm. Chicago Institute of Neurosurgery and Neuroresearch website. Available at: http://www.cinn.org/other/hemifacial-spasm.html . Accessed February 28, 2007.
Hemifacial spasm. MedLink Neurology website. Available at: http://www.medlink.com . Accessed 4/2/2008.
Hemifacial spasm information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/hemifacial%5Fspasm/hemifacial%5Fspasm.htm . Accessed February 28, 2007.
Vinken PJ, Bruyn GW. Handbook Of Clinical Neurology. Amsterdam: North-Holland Publishing Company; 2011: 675-680.
DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#carbamazepine .