After going for a consultation with a neurosurgeon to discuss the best treatment for your hemifacial spasms, you may have left the appointment with questions that you forgot to ask or didn’t think of until you returned to the comforts of your home. If the surgeon described the microvascular decompression for hemifacial spasm as the best permanent option, you may still not be convinced. Learning more about what makes you a good candidate for the surgery and some facts about the microvascular decompression can help you make your choice with confidence.
What Makes a Patient a Suitable Candidate for This Type of Surgery?
Your age and many other factors help determine whether or not you are a safe candidate for microvascular decompression. The procedure itself carries some risks, as does the general anesthesia that is required. However, the smaller incision that it uses mean that you will be released more quickly from the hospital and spend less time in recovery. Your general health and medical history also must be taken into account.
Tests That Help Determine the Diagnosis
It is vital that you have an MRI before undergoing a microvascular decompression for hemifacial spasm. This diagnostic test takes about an hour and is painless. The test helps the neurosurgeon rule out any other causes, such as a tumor or lesion in your brain. In general, a high resolution MRI (sometimes called a FIESTA MRI, is the best test to see if a blood vessel is compressing the facial nerve on the side of the spasms).
Although the MRI won’t necessarily pinpoint the cause of the hemifacial spasms, it does determine if there is a medical reason for the spasms that may require other types of treatments to resolve the problem. An MRI is also an applicable way to rule out other disorders that are sometimes mistaken for hemifacial spasms, such as blepharospasm and some types of facial dystonia, both of which exhibit similar symptoms.
If the diagnosis is unclear after having the MRI, another type of test can help determine if it is hemifacial spasms. This test is called an electromyography. The EMG usually takes about an hour and is often performed in the neurosurgeon’s office. The technician uses tiny electrodes to send electrical transmissions to the muscles in the face. This causes the muscles to contract and can help the surgeon diagnose the hemifacial spasms correctly.
Most insurance plans will pre-authorize these types of tests once the neurosurgeon orders them, since they want to avoid paying for a surgery if it won’t be beneficial to the patients. Even if your health insurance does quibble about an MRI or additional testing, usually if the neurosurgeon appeals the decision, they will ultimately agree that having the diagnostic test is in the best interest of the patient.
Other Options to Treat Hemifacial Spasms
Unfortunately, oral medications have little to no effect on hemifacial spasm, although Botox injections are a viable option for some patients prior to undergoing MVD surgery. Botox is injected into the facial muscles and the symptoms usually decrease or completely go away. The bad news is that the injections are not permanent. Generally, the effects only last for about three to six months.
Other possible side effects include pain at the injection site, flu-like symptoms and dry eyes. More problematic side effects include droopy eyelids, raised eyebrows or a crooked smile. Rare, but serious side effects of the Botox injections can include overall muscle weakness, loss of bladder control or difficulty breathing. Vision problems and difficulty swallowing or speaking are also some rare side effects that can occur.
Facts About Microvascular Decompression
Studies show that over 90 percent of people who undergo microvascular decompression surgery have permanent relief from the symptoms of hemifacial spasm. Fewer than 5 percent of patients experience significant complications.
Although every patient needs to be assessed independently, the majority of people who undergo microvascular decompression surgery for hemifacial spasm experience immediate relief from the facial contortions.
Since the surgeon makes an incision that is usually one inch or less, your recovery time is less than it would be if you had a traditional surgery. Many people also find it financially impossible to take off a couple of months for a traditional surgery. With the decreased recovery time, some patients are able to return to their jobs within two or three weeks. Of course, this depends upon what type of occupation they have. If you have a job that allows you to work at a desk, you are more likely to be given permission to return to work than someone who has an occupation that involves heavy labor.
Microvascular decompression surgery can be a viable, permanent solution for hemfacial spasm. It is considered a relatively safe procedure when it is performed by a skilled neurosurgeon with experience in treating this disorder. This type of procedure has a long history of positive outcomes, and it is very likely to be a surgery that results in total relief of this uncontrollable disorder for you and others like you. The beneficial aspects of this surgery are conclusive enough to drastically improve the quality of life that you enjoy.
