BLEPHAROSPASM
Blepharospasm is a condition in which eyelid muscles persistently and involuntarily twitch. The process originates in the brain, not the eyelids, and is absent during sleep.
It is most often bilateral and occurs more often in women than men and while an exact cause is unknown, risk factors include head or facial trauma, family history of dystonia, and some medications, such as those used to treat Parkinson’s disease.
First-line treatment involves injections of botulinum toxin A (Botox), typically every 3 months, because there is less risk involved than with the more invasive procedures. Systemic medications are often not effective and side effects restrict the dose that can be administered.
Ablation of the facial nerve permanently weakens the facial muscles and the spasm often recurs. Myectomy (surgical removal of the eyelid and brow-squeezing muscles) has a higher incidence of complications than the other treatments.
Call today to schedule an appointment with Dr. Shin (702) 896-2020.
HEMIFACIAL SPASM
Hemifacial spasms are persistent involuntary contractions of the facial muscles on one side of the face.
It can be caused by injury, a tumor, compression by a blood vessel (e.g. by the anterior inferior cerebellar artery where the nerve begins at the brainstem), or Bell’s palsy affecting the facial (7th cranial) nerve, which originates in the brainstem and exits the skull beneath the ear where it branches into five nerves to control the muscles of facial expression.
An MRI/MRA/CT scan may help elucidate whether a brain tumor, aneurysm, arteriovenous malformation, or lesion in the internal auditory canal is the culprit.
As with blepharospasm, it is preferentially treated with botulinum toxin A injections every 3-4 months. BOTOX® blocks the release of neurotransmitter acetylcholine so the muscles do not receive the message to contract.
Various anticonvulsant and muscle relaxant medications have been used to treat hemifacial spasm, but the efficacy is limited and patients are often intolerant of side effects.
Surgery-microvascular decompression-can is effective, but is not without significant risks, including intracerebral hemorrhage, facial paralysis, deafness, and death.
Call today to schedule an appointment with Dr. Shin (702) 896-2020.
