Facial hemispasm

With facial hemispasm there are involuntary unilateral, painless, spastic contractions of mimic muscles.
 * typically start at the m. orbicularis oculi and descend to the mimic muscles of the face and periorally;
 * atypical form: starts buccally and spreads upward;
 * most often caused by compression of the REZ (root entry zone) facial nerve a. cerebelli inferior anterior.

Differential diagnosis

 * facial myokymia (continuous spasm, may be a manifestation of a tumor brain stem / multiple sclerosis);
 * blepharospasm;
 * hemifacial spasm persists in sleep.

Treatment of facial hemispasm

 * microvascular decompression n. VII (success rate 70-90%) - the main risk of surgery hearing damage (manipulation of n . VIII, necessary intraoperative monitoring BAEP), other risks are injury to the decompressed n. VII or damage to the cerebellum;
 * "elderly and high-risk patients": local application of botulinum toxin to the muscle affected by the spasm, the effect lasts for about 5 months, after which the application must be repeated.

Related Articles

 * Facial nerve palsy
 * Trigeminal neuralgia