Living with hemifacial spasm may be leaving you feeling as though you’re completely alone. You’re not – an estimated 11 people out of every 100,000 suffer from this condition on a daily basis. Advances in neurological medicine and surgery have made it possible for you to find effective relief from the debilitating symptoms.
An Overview of Hemifacial Spasm
For years, it was thought that hemifacial spasm was idiopathic – that is, of an unknown origin. More recently, through targeted studies and the use of specialized imaging techniques, researchers have discovered that hemifacial spasm is actually a malfunctioning of the seventh cranial nerve.
In the majority of hemifacial spasm cases, the nerve is being compressed and irritated by an adjacent blood vessel, such as an artery or vein. In more rare instances, there may be some damage to the nerve or brainstem.
Hemifacial spasm most often occurs on only one side of the face. It is characterized by its telltale “grimace” that the involuntary muscle spasms cause. It can start out as a slight twitching around the eye region. As it progresses, other areas of the face may become affected.
Unfortunately, without treatment, hemifacial spasm will continue to progress. It doesn’t go away on its own; many people assume that it is much like a stress-related facial tic and will just dissipate. If you’re experiencing hemifacial spasm, seeking treatment should be your top priority before it becomes a debilitating condition that affects every facet of your life.
Treating Hemifacial Spasm
Hemifacial spasm has shown that it responds well to a few treatments, giving you relief from the symptoms. From Botox injections to surgery, you have options that can allow you, with the help of your doctor, to get back to your life and leave hemifacial spasm symptoms behind.
Botox Injections
Botox injections have also proven to be effective in the temporary relief of hemifacial spasm symptoms. These injections use a refined, medical-grade version of the botulinum toxin to paralyze the muscles and nerves of the face. It is localized, meaning it will only affect the areas into which it is injected, making it a convenient option for targeted treatment.
The downside to Botox injections is that they typically only last about three months and then must be repeated. They can also become less effective over time, meaning they either need to be done more frequently or just quit working altogether.
Botox injections are done as an outpatient procedure. You will need to make an appointment with your doctor and can expect to spend upwards of an hour there. He or she will prepare your skin for the injections. Tiny needles will be used to deliver the solution to the areas that your doctor has determined will give you the highest level of relief. Once the procedure is finished, you will be able to return home. You may experience some injection site swelling and tenderness. You can apply an ice pack to help relieve the discomfort.
Botox injections are ideal if you’re only looking for temporary relief or cannot withstand the general anesthesia associated with surgery. The most common side effect associated with Botox is a permanent paralysis of the muscle or muscles it has been injected into. This is typically found more in long-term use cases.
Microvascular Decompression Surgery
If you’re looking for a more permanent treatment option for your hemifacial spasm, microvascular decompression (MVD) may be the perfect option for you. This procedure uses the most advanced techniques in neurosurgery to bring you long-lasting, side-effect-free relief.
You will need to be thoroughly assessed before undergoing this surgery, as it is done under general anesthesia. You must be in good health to be a candidate. Your doctor will send you for a FIESTA-MRI to determine whether your hemifacial spasm is being caused by a vascular compression or not. If it is found that a blood vessel is interfering with your seventh cranial nerve, you will be scheduled for surgery.
In order to prepare for surgery, you may need to have bloodwork done. Your doctor will advise you on where to go to have your blood drawn. On the day of surgery, you will check into the hospital. You’ll be taken to the surgical preparation area, where you’ll get to talk with your surgeon and anesthesiologist about the procedure and their expectations. You may also need to sign additional paperwork. You will then be prepared for surgery, which will include having an IV placed and receiving a sedative.
Once in the operating room, you’ll be put under general anesthesia. Your surgeon will begin by making an incision in the skin about an inch behind your ear. A small portion of bone (about the size of a quarter) will be removed. This will give your surgeon access to the nerve and offending blood vessel. Using specialized surgical instruments and a microscope, your surgeon will locate the nerve and blood vessel. After carefully examining the area, he or she will carefully lift the blood vessel away from the nerve and place a tiny Teflon sponge between the two. This sponge will provide a buffering effect. After checking nerve function, the doctor will close your skull with a bone replacement and suture the skin back into place. You’ll then be taken to a post-operative recovery area.
Once you’re awake and your vitals are stable, you will be moved to the ICU for overnight observation. It’s possible that you will notice a change in your hemifacial spasm symptoms right away. The following days may be spent in a regular room. The majority of people who undergo microvascular decompression surgery return home after one to three days in the hospital.
Once home, be sure to rest as much as needed. You’ll feel more tired than you usually do, which is normal. Your body is healing and will require more downtime. Be sure to eat a well-balanced diet and take your pain medications on time. Taking short walks several times a day can help speed the healing process – this mild exercise increases blood flow and oxygenates your blood. It’s incredibly helpful to have someone helping you with daily tasks during this time.
After the first week, you will start to feel your energy returning. You should still be taking it easy, but can increase your activity as your energy level allows.
By the second week, you may be able to return to work, particularly if you work in a light-duty occupation, such as a desk job. More strenuous jobs may require additional time off work for adequate recovery. You will also be scheduled for follow-up appointments. It’s important to attend all of these so that your surgeon can monitor your progress.
