Asked by
sunny
in
Personal Health
at
8:31 PM on March 26, 2008
Dr.Anil's Answer
Hemifacial spasm (HFS) is characterized by tonic and clonic contractions of the muscles innervated by the ipsilateral facial nerve. It is important to distinguish this from other causes of facial spasms, such as psychogenic facial spasm, facial tic, facial myokymia, blepharospasm, and tardive dyskinesia. Magnetic resonance imaging and angiography studies frequently demonstrate vascular compression of the root exit zone of the facial nerve. Importantly, an underlying space-occupying lesion needs to be excluded in patients with associated atypical features such as facial numbness and weakness. Botulinum toxin injection to the facial muscles is an effective treatment for HFS, with few disabling side-effects.Commonly known as Facial twitchings.
Patients with HFS usually present at between 40 and 50 years of age. They frequently complain of involuntary eye closure, which interferes with vision and causes social embarrassment.The facial spasms are spontaneous and may persist during sleep. Symptoms are frequently aggravated by stress, fatigue, anxiety, and voluntary facial movements. Relaxation, alcohol intake, touching the affected areas, and exercise reportedly improve symptoms in some patients.
Treatment:-
1.Drug s:-The efficacy of oral medications is often transient. Carbamazepine, anticholinergics, baclofen, clonazepam, haloperidol and recently gabapentine have all been used.
2.Botulinum toxin injection
Botulinum toxin (BTX) is one of the most potent biological toxins known. The toxin is a zinc endopeptidase that acts on one or more of the neurosecretory proteins in the presynaptic nerve terminal. It inhibits the calcium-mediated release of the acetylcholine into synaptic junction resulting in local chemical denervation and loss of neuronal activity in the targeted organ.
3.Surgery
Microvasc ular decompression (MVP) of the facial nerve at the cerebellopontine angle, the most common surgical procedure carried out today, results in markedly improved HFS in the majority of patients, with success rates of >90% in some series.8 However, a recurrence rate of up to 20% has been reported.
4.Extracranial neurosurgical operations involving sectioning the peripheral nerve trunk or its branches, unilateral removal of the orbicularis oculi and corrugator superciliaris muscles, injection of alcohol or phenol to injure the facial nerve, and percutaneous puncture of the facial nerve at the stylomastoid foramen have all been used with varying success in the past and seldom performed nowadays.
NO,THE ANSWER TO YOUR QUESTION IS NO,AS THERE IS NO PERMANENT CURE FOR FACIAL TWITCHING UNLIKE TEMPORARY CURES LIKE BOTULINUM TOXIN AND DRUGS AS MENTIONED ABOVE
Answered at
12:45 AM on March 27, 2008
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