Hemi facial spasm: Medical and neurosurgical treatment

Abstract

Hemi facial spasm (HFS) is characterized by clonic contractions of the muscles innervated by the facial nerve. The differential diagnosis is very important in order to distinguish this from other causes of facial spasms, such as blepharospasm, psychogenic facial spasm, facial tic, facial myokymia, and tardive dyskinesia. Magnetic resonance imaging (MRI), MRI-Angiography (MRIA) and 3D-angiography studies frequently demonstrate vascular compression of the facial nerve. Also the neuroimagistic data are important to exclude the patient with space-occupying lesion. Botulinum toxin (BTX) injection to the facial muscles is an effective treatment for HFS, with few disabling side effects, but the results are faire only for 3 - 6 months. Micro vascular decompression (MVD) represents the best method to cure HFS with good results in time.