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- What Is Hemifacial Spasm and What Can You Do About It?
What Is Hemifacial Spasm and What Can You Do About It?
If you have felt problems with one side of your face in which involuntary muscle contractions are taking place, often causing you to display facial expressions that do not convey your mood or anything you are trying to say, you may be suffering from a hemifacial spasm.
The name of this condition goes some way towards explaining just what it is. The ‘hemi’ part means half (like a hemisphere means half the globe), while the facial is just that - the face. It means this condition will leave you with muscle spasms on one half of the face while leaving the other unaffected.
Affecting around one in 1,000 people, its most likely cause is a neurovascular conflict, which means the cranial nerve responsible for facial movements (known as the facial nerve) is being pressurised by contact from an adjacent blood vessel close to where it exits the brain.
Far less frequently, the nerve can be pressurised by a tumour. The condition is not, however, genetic or hereditary.
A neurovascular conflict is a feature of ageing, as blood vessels tend to become more serpentine in shape, meaning one of them may be more likely to come into close contact with nerves (including smaller nerves surrounding the larger ones) and cause problems of this kind through transmitting confused signals.
According to consultant Professor Ludvic Zrinzo, this is rather like the ‘crossed wires’ that used to happen in the early days of telephones, with the wrong nerve signals leading the face to do things you don’t intend. The technical term for this is ‘lateral spread’.
On the plus side, this procedure does tend to be very effective and most patients are cured. It should be noted, however, that this option does come with some risks, not least because the surgery can lead to facial nerve damage.
The level of risk can depend on a range of factors, but the most notable of these is the size of the blood vessel involved, with a larger vessel posing a greater risk as the surgery will need to be more extensive to move it.
Surgery is quite a major step and could involve multiple nights in hospital, although this will be well worth it for a successful procedure. Nonetheless, given it is not always successful and comes with risks, it is worth considering alternatives, which may be tried first to see how well they work before making any final decision over the surgical option.
Botox can bring some side effects, such as a drooping eyelid, but this usually wears off quickly. However, if the side effects prove severe and lasting, or the treatment does not do enough to stop the spasms, the case for surgery may be a more compelling one.
Nonetheless, if this approach is sufficient to ameliorate your symptoms, it could offer the best option for you, not least as it does obviate the risk that must be taken into account when making an informed choice about the surgical option.
Medication through drugs is a further alternative option, although the calming effect this may have on the facial nerve will likewise affect other nerves and functions, bringing with it side effects like drowsiness or brain fog. Therefore, it is unlikely to be your best option.
Some people may consider a hemifacial spasm to be a condition they can live with and cope with, especially as it has no wider physical health consequences. But for those who suffer feelings of embarrassment, depression, anxiety, or isolation because of it, it may be reassuring to know there are effective treatment options available.
The name of this condition goes some way towards explaining just what it is. The ‘hemi’ part means half (like a hemisphere means half the globe), while the facial is just that - the face. It means this condition will leave you with muscle spasms on one half of the face while leaving the other unaffected.
How Hemifacial Spasm Is Caused
Like any other neurological condition that affects muscles and nerves, it doesn’t ‘just’ happen, but usually has a specific and identifiable cause. Because it is linked to electrical signals, the use of electrical stimulation tests can be used to help diagnose it and confirm suspected cases.Affecting around one in 1,000 people, its most likely cause is a neurovascular conflict, which means the cranial nerve responsible for facial movements (known as the facial nerve) is being pressurised by contact from an adjacent blood vessel close to where it exits the brain.
Far less frequently, the nerve can be pressurised by a tumour. The condition is not, however, genetic or hereditary.
A neurovascular conflict is a feature of ageing, as blood vessels tend to become more serpentine in shape, meaning one of them may be more likely to come into close contact with nerves (including smaller nerves surrounding the larger ones) and cause problems of this kind through transmitting confused signals.
According to consultant Professor Ludvic Zrinzo, this is rather like the ‘crossed wires’ that used to happen in the early days of telephones, with the wrong nerve signals leading the face to do things you don’t intend. The technical term for this is ‘lateral spread’.
How Surgery Can Help
While this can be very bad news when symptoms strike, the fact this nerve issue is the usual cause of hemifacial spasm means there is a clear surgical solution, which lies in diverting the blood vessel away from proximity with the nerve, a process known as microvascular decompression.On the plus side, this procedure does tend to be very effective and most patients are cured. It should be noted, however, that this option does come with some risks, not least because the surgery can lead to facial nerve damage.
The level of risk can depend on a range of factors, but the most notable of these is the size of the blood vessel involved, with a larger vessel posing a greater risk as the surgery will need to be more extensive to move it.
Surgery is quite a major step and could involve multiple nights in hospital, although this will be well worth it for a successful procedure. Nonetheless, given it is not always successful and comes with risks, it is worth considering alternatives, which may be tried first to see how well they work before making any final decision over the surgical option.
Alternatives To Surgery
A common and effective way to treat the condition is with Botox. This weakens the muscles, which means the spasms cannot be nearly as intense. For many patients, this is very effective, although the one downside is that, just like for patients who use Botox to hide wrinkles, it wears off and needs to be reapplied on a regular basis.Botox can bring some side effects, such as a drooping eyelid, but this usually wears off quickly. However, if the side effects prove severe and lasting, or the treatment does not do enough to stop the spasms, the case for surgery may be a more compelling one.
Nonetheless, if this approach is sufficient to ameliorate your symptoms, it could offer the best option for you, not least as it does obviate the risk that must be taken into account when making an informed choice about the surgical option.
Medication through drugs is a further alternative option, although the calming effect this may have on the facial nerve will likewise affect other nerves and functions, bringing with it side effects like drowsiness or brain fog. Therefore, it is unlikely to be your best option.
Some people may consider a hemifacial spasm to be a condition they can live with and cope with, especially as it has no wider physical health consequences. But for those who suffer feelings of embarrassment, depression, anxiety, or isolation because of it, it may be reassuring to know there are effective treatment options available.
