If you are afflicted with hemifacial spasm, it’s likely that you yearn to find an effective and permanent solution to the disorder. This isn’t a medical condition that you can hide from your family, friends, coworkers or acquaintances. The twitching that occurs as a result of this disorder is often described as uncomfortable, humiliating and embarrassing. Learning about the disorder and the different types of treatments available can help you to determine which option is most likely to bring a resolution to your facial discomfort.
Information About the Disorder
Everyone has experienced a twitch in their facial muscles occasionally, such as an annoying small twitch in the eye area. Hemifacial spasms are different from this random occurrence. This disorder involves the nervous system, and the spasms occur frequently and, sometimes, almost constantly. Hemifacial spasms typically occur on one side of your face. The symptoms also include contractions that force your eye to shut or cause your mouth to draw to one side. The cause is sometimes unknown, but it could result from a tumor, an injury or something pressing on the nerve, such as a blood vein. Nerve pressure is the most common cause of this disorder.
Treatment Options
Using prescription drugs for hemifacial spasm treatment is not a viable option because drugs generally have little or no effect on the facial contractions. Your physician may suggest you try injections of botulinum toxin (Botox). Botox is typically injected into the affected muscles, but it’s only a temporary solution and can have unpleasant side effects. A majority of patients experience a decrease in facial twitching for three to six months before there is a need for another injection. Although many patients tolerate the injections well, many others experience facial muscle weakness.
Effectiveness of Microvascular Decompression (MVD)
Microvascular decompression (MVD) is a permanent way to rid the patient of the involuntary facial spasms. Research shows that many patients who undergo MVD surgery receive total relief from the twitching and other symptoms of hemifacial spasms. The incision is quite small, so the recovery process is much faster than with a traditional surgery.
Risks of the Procedure
Every surgical procedure involves risks, however, when MVD surgery is performed by an experienced neurosurgical team, serious risks are significantly minimized. Your surgeon will discuss the risks involved and the odds of them occurring before you agree to the procedure.
Rare side effects include decreased hearing on the side of the spasms, infection, stroke, or leaking of cerebral spinal fluid (CSF). Many patients feel that returning to a lifestyle that is free of facial spasms and the need for repeat Botox injections are well worth the risk.
What Happens During the Surgery?
You will be prepped for the surgical procedure and be given a general anesthesia (you are asleep during surgery). The neurosurgeon shaves a relatively small section of your hair behind your ear. Then, a small incision is made in the back of your head. Using a sophisticated operating microscope, the facial nerve, as well as the blood vessel(s) causing discomfort, are isolated. Next, a small, sponge-like barrier, typically made of Teflon, is carefully placed between the nerve and blood vessel. This cushions the facial nerve while preventing the heat and hemifacial spasms. The covering over the brain is repaired using sutures and sealants for a water-tight closure. The surgeon then places a thin titanium mesh over the area where the bone was removed. Then, a small amount of material similar to bone cement is placed over the titanium for a smooth, cosmetica closure. Sutures are placed to connect the muscles and skin that were involved, and then the patient is moved to the recovery room.
After the Surgery
During your hospital stay, you may experience nausea or have a headache. These problems are easily controlled with medications. You will be sent home within a day or two and given a prescription for pain medication that helps to alleviate any headaches or discomfort you experience. After a couple of days, acetaminophen is usually all that is necessary to control any discomfort.
A post-op visit usually happens 5-7 days after your release from the hospital. At this time, your surgeon provides you with instructions on how to gradually go back to your normal routine. He or she will also discuss how soon you can return to work, depending on your occupation and how well your recovery is going.
With many surgeries, the patient often has to wait weeks to fully recover and to determine if the surgery was a success. However, this is not the case with a microvascular decompression. It’s quite likely that you will notice an immediate absence of the involuntary spasms directly after the procedure.
