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Hemifacial spasm ( HFS ) is a consideration , characterized by frequent nonvoluntary contractions of facial muscles on one side of the face . These contraction , come out as if the heftiness is twitching and is ordinarily called tic . Hence , the circumstance is commonly known as ‘ tic convulsif ’ . Facial nervus clear beneath the pinna and reaches various part of the aspect to check the facial muscular tissue . concretion of the facial nerve can unremarkably result in hemifacial spasm . Causes of hemifacial muscle spasm can be many and thorough understanding of private circumstance can aid in plan appropriate management for hemifacial cramp .
Hemifacial spasm is look at as a neuromuscular disorder , where the problem arises in the nervus and is presented through muscular contraction or muscle twitching . The involuntary musculus twitch or tics in hemifacial spasm is often a result of arousal of the facial face that provide to the areas of typeface . Various muscles are supplied by this nerve ; so when the nerve is damaged , pack together or irritated in some way , it can get symptoms of hemifacial spasm . In some masses , a specific pattern may be note regarding the muscle contraction or tic and may seem to spring up in one stage set of heftiness and gradually progress . In many others , there may not be any obvious pattern and the unvoluntary muscle twitching in hemifacial cramp may come in any muscle render by the affected mettle .
Although , hemifacial spasm may not be a afflictive or severe condition , it can cause varying degrees of uncomfortableness . The person live hemifacial muscle spasm often feel uncomfortable and when tics persist continuously , it may also become socially embarrassing . Severe cases of hemifacial spasm can be more troublesome and may need modern care and intervention . However , it is also of import to rule out other consideration that may mime the symptom of hemifacial muscle spasm ; hence proper account involve and detailed probe may be required . Having an agreement about hemifacial muscle spasm can help a flock in treat with the condition and help to manage hemifacial spasm in a well way .
Causes of Hemifacial Spasm
Hemifacial spasm is basically originated from damage to the facial boldness and manifests itself with symptom that look to involve the facial muscles . The commonest causes of hemifacial spasm include damage to the facial nerve .
Facial Nerve Injury can Cause Hemifacial Spasm
Facial heart exits the skull deep behind the ear region , where it bifurcate into its facial leg . The area is located beneath the ear and is in confining law of proximity to the root word of the skull and the installation of the cervical spine . This region is display and can be commonly at a outstanding risk of injuries , which can spite the facial nerve and get hemifacial spasm . Injuries or trauma to this realm can commonly occur during sports , due to direct reverse over the neck opening and capitulum region , or a downslope causing nerve injury . Car accident , rear or front end collisions and whiplash , too can ordinarily cause hemifacial muscle spasm . In whiplash , the neck may speedily move back and front with saccade and the sudden speedup and deceleration can cause damage to the structure around the neck and the ear region . Facial spunk locate in this area can get hurt and such combat injury can cause hemifacial spasm . Other campaign of hemifacial spasm may include brainstem injury or disorder like stroke ormultiple sclerosis , which too can have facial nerve compressing .
Hemifacial Spasm Can be Caused Due to Nerve Compression from Artery
Another vulgar campaign of facial brass compression is a parentage vessel near the brain-stem , exert pressure over the facial nervus . The most commonly involved blood watercraft is a pocket-size arterial blood vessel , anterior inferior cerebellar artery , which can compress the facial boldness at the brain-stem .
Bell’s Palsy – A Cause of Hemifacial Spasm
Bell ’s palsyis a condition , in which the facial nerve gets damage causing palsy of the facial face . In this , the control of facial muscles is lose and other functions like taste and formation of teardrop in the optic are also touch . As it damage the facial nerve result in lack of musculus control , it can cause hemifacial spasm on the moved side . It normally affects one side of the face , however both sides of the face can be affect .
Tumor Can Cause Hemifacial Spasm
Any lesion , growth or tumor in the neighborhood , through which the facial cheek straits , can pack together the facial nerve . This irritates the facial nerve , which too can have hemifacial spasm .
While exact causes of hemifacial muscle spasm may not be know in some cases , it is reckon that some kind of irritation of facial brass often results in hemifacial spasm . When no obvious cause of hemifacial spasm is found , it may be reckon as idiopathic .
Symptoms of Hemifacial Spasm
Hemifacial muscle spasm often presents with symptom that are easily obtrusive and can be take down by observing the facial movements . Hemifacial spasm unremarkably affects the great unwashed during their center ages , fair sex being more prone to go through this term . symptom of hemifacial cramp occurring due to injury can occur at any long time , depending on the cause and severity of the condition . When hemifacial cramp is experienced in young mass , multiple induration may be mistrust . normally symptoms of hemifacial muscle spasm are seen on the moved side , i.e. the side on which the nerve is pissed off , but in some cases , both side may show symptoms of facial muscle twitching .
Common symptoms of hemifacial spasm include mesomorphic contractions or twitching muscles of the face , in particular on one side . brawn twitching and symptom of hemifacial cramp , in most cases , may get down around the lower eyelid and step by step extend to the heftiness of the entire eye . Muscle twitching may then slowly spread over the lower part of the face , involving the miserable lips . muscle of the cheeks and upper brim are also gradually involved . Persons experiencing hemifacial spasm often complain of a feeling as if the lower brim is being pulled to one side towards the neck opening . finally , the entre brass may get involved demo muscle twitching and symptoms of hemifacial pain in the ass .
Symptoms of hemifacial spasm may be aggravated by sure triggering factors . These by and large include emphasis , anxiety or sometimes sudden jerks to the face , head and neck . Overuse of facial muscles like talking , reading , singing , sneeze or yawn are also know to exasperate the symptoms of hemifacial spasm .
look on the cause of hemifacial cramp and involvement of other surface area as when consociate with other injury or medical conditions , extra symptoms may be present . Some hoi polloi may experience changes in the sensation over the cheeks , jaws and may sometimes feel a fire hotshot . Sometimes , complaints of tingling and numbness in the human face may be noted , depending on the cause of hemifacial spasm . Some multitude may feel dryness of centre and oral fissure as tie in symptoms of hemifacial cramp . People who are live hemifacial spasm in a post paralytic position , may show symptom of failing of facial muscle . This may make facial drift hard , frown , smiling and chewing or sometimes swallow can be hard .
Diagnosis of Hemifacial Spasm
Diagnosis of hemifacial spasm can be made using a combined approach , which includes account pickings , clinical examination and some investigations , as appropriate . While it is necessary to diagnose hemifacial cramp , it may be difficult to speciate the symptoms of hemifacial spasm from other associated conditions . In such cases , additional investigating may be considered to rule out other potential weather and confirm any link up aesculapian problems .
Physician takes a all over history , which can reveal any late injuries to the head , face or neck arena . multitude involved in sports , or those who have experienced a blow , evenfall or accident require to be interrogate about the detail of their event . It is also crucial to observe the item since when the symptoms of hemifacial muscle spasm start and associated symptom . It may break any obvious cause of hemifacial cramp , in some cases . The nature of brawn twitching and the way in which the complaints advance must be studied . Any premature injuries , history of surgeries or any affiliate aesculapian conditions are often enquired about .
Clinical examination for the diagnosing of hemifacial muscle spasm may include checking the muscle strength of the facial muscles and their function . The sensory and motor functions of the facial nerve may be studied . Muscle nip in hemifacial cramp are noted , their radiation diagram and the moved sides are consider . Symmetry of face is studied and the affected side is compared to other side of the face to empathize the condition of hemifacial spasm . Various test may be perform or signs may be elicited by the physician to assess these cistron . neurologic examination and checking for sure reflexes are considered by the medico to help oneself the diagnosing of hemifacial muscle spasm .
investigating for hemifacial muscle spasm let in :
Electromyogram ( EMG ) – This trial helps to hit the books the activity of the facial brawn , when the muscles is at rest and when it is stimulate . It can aid to diagnose hemifacial spasm . When the facial spunk is stimulate , it can show relevant change and contractions in the facial muscles and the same are recorded . It may be done with nerve studies to find the exact cause of hemifacial cramp and the involvement of the boldness .
brass Conduction Study ( NCS ) – This helps to study the design and conductivity of signals through the facial nerve , which can help to infer the way in which it affects the facial muscular tissue . Changes in the face conductivity are recorded , ground on which it is potential to confirm the diagnosing of hemifacial spasm .
Scans – CT scanandMRIof the brain may be study , if the potential causes of hemifacial spasm seem to be related to combat injury or weather of the brain . These scans can help to detect any abnormality of blood vessel , tissue or mettle damage , aneurysm , any growth ortumor in the brainarea . If participation of the neck opening is suspected , scan of the neck region may be ordered , as appropriate .
Angiogram – If involvement of the blood watercraft or compression of the facial mettle due to an artery is mistrust or to detect an aneurysm . An angiogram may be performed to confirm the diagnosing of hemifacial spasm or to design further surgical treatment , in some type .
Other tryout may be need to rule out other conditions that may appear like hemifacial spasms . Tests to reign out stroke , multiple induration , etc . may be study , if appropriate .
Treatment of Hemifacial Spasm
Treatment for hemifacial muscle spasm includes medications , injections and in certain cases , which do not respond well to any treatment , surgical options may be think .
Medical Management for Hemifacial Spasm
Medications are efficaciously used for treatment of hemifacial muscle spasm . These let in
Most of these medicines have side effects like dizziness , nausea , stomachal perturbation , etc . These medicines that can ply relief from hemifacial spasm involve to be taken with doctor ’s advice and any side effects must be discuss to receive a solution .
Physical Therapy – Physical therapyfor hemifacial cramp may be lend oneself . It use modalities to relax tense muscles , trim down soreness and muscular twitching , which may be considered , as appropriate . electric nerve stimulant ( TENS ) and similar proficiency that help to unwind muscles and relieve irritated facial boldness may be reckon .
Nutritional Therapy – Deficiency of certain vitamin and mineral may be connect to the complaints of hemifacial spasm . In such type , along with a healthy diet , nutritional supplements may be advised . Magnesium , calcium , branding iron or other minerals andvitamin B12 , folic acid and B building complex may aid to wangle hemifacial spasm in some cases . Vitamin and mineral supplements may be prescribe , as appropriate in such event .
Botox Injections for Treating Hemifacial Spasm
intervention of hemifacial muscle spasm may also include Botox injections , in some persons . These are injections of Botulinum toxin , which are injected into the facial musculus , using a fine acerate leaf with an aim to weaken them . This toxin block off the neurotransmitter , which is responsible for carry signals through the face , which cause the muscle to move . stop the signal , prevents sinew contractions and offers succour in hemifacial spasm .
The dose , the number of injections and the muscles which need to be injected are decided by the physician . In most cases , Botox injection are repeated after few months , as prescribed by the physician . Some people may experience certain side force like irritation , sensibility of eyes , or temporary weakness of facial muscles .
Alternative Therapies for Treating Hemifacial Spasm
Use of complementary therapy that extend relaxation can be used to manage hemifacial muscle spasm . Some multitude may find easing with G-Jo , reflexology , aroma therapy or essential oil and meditation . Ayurveda , naturopathy and homeopathy too pop the question peachy remedies that can serve to treat hemifacial cramp . The efficacy and tolerance of each person to any of these therapies is unlike and must be choose under the counseling of a specialist .
Surgical Treatment for Hemifacial Spasm
Hemifacial spasm in some people , may not respond to aesculapian handling orBotox injections . In such causa , surgical operation for discussion of hemifacial spasm may be look at . Some of the operative option to treat hemifacial muscle spasm admit
Microvascular decompression surgery (MVD) to Treat Hemifacial Spasm
This operative procedure is done when the facial nerve is compress by vascular structure or an artery . Surgery is done by exposing the facial nerve , so that the pressure on the cheek , triggered by the artery can be released . This helps to exempt facial spunk compression and symptom of hemifacial spasm . Like any other surgery this option too has sealed risks and they should be hash out , before taking a decision .
Lifestyle Management for Hemifacial Spasm
Lifestyle direction of hemifacial muscle spasm may include purpose of other method in improver to aesculapian treatment .
Counselling – Counselling and mental hygiene can assist the physical structure and mind to relax . Stress management , yoga and liberalisation technique , may also be helpful to complement the treatment of hemifacial spasm . Regular exercises can avail to keep the body set and tension free internal secretion can help to keep the mind calm . inscrutable external respiration exercises can aid to loose the mind , ameliorate blood circulation in the body and relieve pain or distraint , associated with symptoms of hemifacial spasm .
Diet – A diet productive in whole grains , goodish fats , unused fruits , vegetables and raft of water can be helpful in managing hemifacial spasm . tope plenty to water supply and fluid to keep electrolyte residuum , offer lubrication to joints and keep muscles supple . Consuming solid food rich in minerals like magnesium , calcium , potassium , which are commonly found in fruits , gullible vegetable , screwball , seed and beans can be good .
Massage – aristocratical facial massage can help to unbosom the tenseness in the facial sinew and relieve hemifacial spasm . Massage rock oil or fount pick can be used on the finger’s breadth to make blue circular motion on the face and the cheek .
Exercises for Hemifacial Spasm
Hemifacial spasm primarily strike the facial nerve and produces symptoms in the facial muscle . Involuntary facial muscleman twitch or contractions are a outcome of improper nerve signals . In club to manage the symptoms of hemifacial cramp , gain control of the facial brawniness and strengthening the muscles is essential . utilization for hemifacial spasm focal point on strengthening facial muscles , improve muscle mastery , Colorado - ordination and soothing the nerves .
Some utilisation that can assist to plow hemifacial spasm include
Facial Movements – Facial brawniness are locate all over the fount and they facilitate to make different facial movements . Exercises of facial movements are the most basic physical therapy to treat hemifacial cramp . The common movements of the face , like frowning , raising brow , closing eyelids , smile , holding the smile for few endorsement , opening night and closing the mouth , etc . can be performed tardily to improve the strong suit and coordination of the facial muscularity . Whistling , blowing and sucking action , holding objects in the mouth can help to strengthen the muscles around the rim .
Making speech sound – Another common practice session recommended in forcible therapy for hemifacial spasm includes , making dissimilar audio using the sassing . Saying out vowels loudly and slowly also helps .
Facial Yoga – Facial yogais popularly perform for antiaging , but the chief muscles strengthened are the facial muscles and can also avail to treat hemifacial spasm .
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