परिभाषा
Hemifacial spasm is a neuromuscular disorder that causes frequent involuntary contractions to occur in the muscles on one side of the face.
का कारण बनता है
Hemifacial spasm is believed to be due in part to compression of the facial nerve where it meets the brainstem. The compression can be cause by:
- A blood vessel pressing on the facial nerve (most frequent cause)
- फोडा
- Facial nerve injury
- Bony or other abnormalities that compress the nerve
जोखिम कारक
The following factor increases your chance of developing hemifacial spasm:
- Being a middle-aged or elderly woman
- उच्च रक्तचाप
लक्षण
- Intermittent twitching of the eyelid muscle
- Forced closure of the eye
- Spasms of the muscles of the lower face
- Mouth pulled to one side
- Continuous spasms involving all the muscles on one side of the face
निदान
आपका डॉक्टर आपके लक्षणों और चिकित्सा इतिहास के बारे में पूछेगा, और एक शारीरिक परीक्षण करेगा। परीक्षणों में निम्नलिखित शामिल हो सकते हैं:
- Electromyography (EMG) —a test that measures and records electrical activity generated in muscle at rest and in response to muscle contraction
- Magnetic resonance imaging (MRI) —a test that uses magnetic waves to make pictures of structures inside the head
- Computed tomography (CT) scan —a type of x-ray that uses a computer to make pictures of structures inside the head
- Angiography —an x-ray exam of the blood vessels when they are filled with a contrast material
उपचार
Hemifacial spasm is usually a chronic condition. Remission of symptoms, although possible, has only been noted to occur in less than 10% of patients.
आपके लिए सर्वोत्तम उपचार योजना के बारे में अपने डॉक्टर से बात करें। उपचार के विकल्पों में शामिल हैं:
दवा
- Carbamazepine —This is often used initially, with improvement in symptoms in up to half of patients who are treated.
- According to the Food and Drug Administration (FDA), patients of Asian ancestry who have a certain gene, called HLA-B*1502, and take carbamazepine are at risk for dangerous or even fatal skin reactions. If you are of Asian descent, the FDA recommends that you get tested for this gene before taking carbamazepine. If you have been taking this medicine for a few months with no skin reactions, then you are at low risk of developing these reactions. Talk to your doctor before stopping this medicine.
- Gabapentin and baclofen —These may also be beneficial for treating hemifacial spasm in some patients.
Botulinum Toxin Injections
Injecting botulinum toxin (ie, Botox) into the affected muscles can stop eyelid spasm for several months. These injections must be repeated, usually several times a year. Botulinum toxin injections are the treatment of choice.
सर्जरी
Microvascular decompression surgery repositions the blood vessel away from the nerve. This is successful in cases of hemifacial spasm where the cause is suspected to be a blood vessel compressing the facial nerve.
रोकथाम
There is no known way to prevent hemifacial spasm.