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Hemifacial spasm (HFS) is a rare neuromuscular disease characterized by irregular, involuntary muscle contractions on one side (hemi-) of the face (-facial). [1] The facial muscles are controlled by the facial nerve (seventh cranial nerve), which originates at the brainstem and exits the skull below the ear where it separates into five main branches.
Around 9% of people have some sort of ongoing problems after Bell's palsy, typically the synkinesis already discussed, or spasm, contracture, tinnitus, or hearing loss during facial movement or crocodile-tear syndrome. [50] This is also called gustatolacrimal reflex or Bogorad's syndrome and results in shedding tears while eating.
Microvascular decompression (MVD), also known as the Jannetta procedure, [1] is a neurosurgical procedure used to treat trigeminal neuralgia (along with other cranial nerve neuralgias), a pain syndrome characterized by severe episodes of intense facial pain, and hemifacial spasm.
[46] [47] Injections are generally administered at intervals of around 10 weeks, with variations based on patient response and usually give fairly quick relief from the muscle spasms. An English study reported that 118 (78%) of 151 patients experienced significant relief of symptoms for a mean duration of 9.2 weeks. [ 11 ]
In patients with severe injury, progress is followed with nerve conduction studies. If nerve conduction studies show a large (>90%) change in nerve conduction, the nerve should be decompressed. The facial paralysis can follow immediately the trauma due to direct damage to the facial nerve, in such cases a surgical treatment may be attempted.
Bright light therapy is a treatment method that involves exposure to a high-intensity light source that mimics natural sunlight, says Frank A. Ghinassi, Ph.D., senior vice president of Behavioral ...
Neuro-ophthalmology is mostly non-procedural, however, neuro-ophthalmologists may be trained to perform eye muscle surgery to treat adult strabismus, optic nerve fenestration for idiopathic intracranial hypertension, and botulinum injections for blepharospasm or hemifacial spasm. [5]
In December 1989, Botox was approved by the US FDA for the treatment of strabismus, blepharospasm, and hemifacial spasm in people over 12 years old. [111] In the case of treatment of infantile esotropia in people younger than 12 years of age, several studies have yielded differing results. [57] [155]