| 제목 | Hemifacial spasm is | ||
|---|---|---|---|
| Name | 관리자 | Date | 2014-07-02 |
내용
Hemifacial spasm is a disease where half of the face starts spasms without the person’s will and it refers to the condition in which intermittent and abrupt constriction occurs in the facial muscles where the facial nerves are distributed.
Clinical symptoms
Symptoms include involuntary spasms that start at the eye and get worse. The eyes get closed and the mouth goes up repeatedly.
In most cases, the symptoms occur in only one part of the face and unlike other motor abnormalities, symptoms can occur in sleep. It occurs commonly when the patient is under stress, nervous, or when meeting someone unfamiliar. If the symptoms are serious, it brings problems in interpersonal relationships and the patient can experience depression.
In most cases, the symptoms occur in only one part of the face and unlike other motor abnormalities, symptoms can occur in sleep. It occurs commonly when the patient is under stress, nervous, or when meeting someone unfamiliar. If the symptoms are serious, it brings problems in interpersonal relationships and the patient can experience depression.
Reason why it occurs and the mechanism
There are 12 types of cranial nerves in our brain that are responsible for various movements and senses. The 7th one is the facial nerve, which controls the face and especially the muscles of the eye and around the mouth.
In most cases, when the facial nerve is pressured by the blood vessels, the facial nerve is damaged and the neurofibers get attached to each other and causes the spasms. However, in rare cases, brain tumor, cerebral aneurysm, and demyelinating disease around the brain stem can cause the spasm. In order to find the secondary cause, an MRI must be done.
In most cases, when the facial nerve is pressured by the blood vessels, the facial nerve is damaged and the neurofibers get attached to each other and causes the spasms. However, in rare cases, brain tumor, cerebral aneurysm, and demyelinating disease around the brain stem can cause the spasm. In order to find the secondary cause, an MRI must be done.
Diagnosis and Tests
Facial spasm has very unique symptoms and it is possible for a specialist to diagnose by examining the medical history and observing the symptoms. However, an MRI and MRA are done to test for a secondary cause and observe the blood vessels and the facial nerve root.
Other tests include electroneuronography in order to confirm the abnormality of the facial nerve electrophysiologically and hearing test since hearing abnormality can sometimes occur postoperatively.
Similar diseases
. Blepharoclonus
Old patients and especially women experience problems opening their eyes, and in this case the patient more or less experiences hindrance. Whenever the patient tries to look at a person or an object, repeated tonic contractions or involuntary clonic contractions occur on the eyelid and the patient must try hard and suffer in order to overcome them.
Old patients and especially women experience problems opening their eyes, and in this case the patient more or less experiences hindrance. Whenever the patient tries to look at a person or an object, repeated tonic contractions or involuntary clonic contractions occur on the eyelid and the patient must try hard and suffer in order to overcome them.
. Blepharospasm
Involuntary contractions repeatedly occur in the muscles of both eyelids. It occurs commonly in old age, gets worse under stress, and disappears during sleep. It looks similar to hemifacial spasm, but the difference is that it occurs on both sides. Sometimes spasmodic dysphonia, torticollis, or other dystonia can accompany the disease. No treatment method has been successful for blepharospasm, but the use of botulinum toxin (this toxin is injected around the orbicularis oculi muscle and in several places on the facial muscle) has shown effects. The effect goes for 3-5 months and in most cases repeated injections are necessary.
Involuntary contractions repeatedly occur in the muscles of both eyelids. It occurs commonly in old age, gets worse under stress, and disappears during sleep. It looks similar to hemifacial spasm, but the difference is that it occurs on both sides. Sometimes spasmodic dysphonia, torticollis, or other dystonia can accompany the disease. No treatment method has been successful for blepharospasm, but the use of botulinum toxin (this toxin is injected around the orbicularis oculi muscle and in several places on the facial muscle) has shown effects. The effect goes for 3-5 months and in most cases repeated injections are necessary.
. Tonic facial spasm
In some cases fasciculation that makes the mouth region go up or the eyes continually close can occur due to cerebellopontine angle lesion. This tonic facial spasm is a different disease from hemifacial spasm and CT scan or MRI is done to check if any structural abnormalities exist.
In some cases fasciculation that makes the mouth region go up or the eyes continually close can occur due to cerebellopontine angle lesion. This tonic facial spasm is a different disease from hemifacial spasm and CT scan or MRI is done to check if any structural abnormalities exist.
. Facial myokymia
It can sometimes occur in diseases like multiple sclerosis. Repeated spontaneous discharge originating from the facial nerve nucleus causes squirmish muscular contractions in the face. It responds well to caramazepine for different cases.
It can sometimes occur in diseases like multiple sclerosis. Repeated spontaneous discharge originating from the facial nerve nucleus causes squirmish muscular contractions in the face. It responds well to caramazepine for different cases.
. Dystonia
Dystonia is a condition where the body or the muscles of the limbs contract abnormally and it indicates symptoms of abnormal postures for a lengthy period of time. In cases where it must be differentiated from hemifacial spasm, there are oromandibular dystonia and drug-induced dystonia.
- Oromandibular Dystonia
It is a condition where blepharospasm, which causes involuntary exertion of stress on the eye for a long period of time and closes the eye, accompanies dystonia of the muscles of the mouth, tongue, and jaw. It is most common in women and patients in their 50s. The gaping of the jaw, puckering of the lips, contraction of the platysma, and sticking out the tongue are the most common symptoms. Botulinum toxin injections or other medications such as phenothiazine are used to treat this condition.
- Drug-induced Dystonia
Psychotropic medications can cause acute abnormal dystonia mostly around the facial and cervical area. It can also cause oculogyric crisis where the eye can deviate upward. Anticholinergic medication is used as treatment.
. Tics and Habit spasm
Many people develop habitual actions during their life. If nervous, simple and unique habits such as sniffling, making nonsense sounds, protruding the jaw, and repeating actions such as blinking can all occur. The characteristic of these conditions is that while repeating the same actions, they cannot be restrained. The patient can temporarily restrain the actions after learning that the actions are being done to relieve stress, but the minute the patient turns their thoughts, they reappear. In some cases tics become so habitual that the patient cannot easily recognize them and it appears that the patient cannot restrain them at all.
The interesting thing is that many tics are normal, intentional actions that blend in well and are observable in individuals. What determines a habitual action or a tic is that it is an endless repetitive action that can be one simple movement (for example, blinking, sniffling, and stretching of the neck) to various complex movements.
Habit spasm occur commonly in children from 5~10. This can refer to blinking, shrugging the shoulders, sniffling, tilting the head or the eyes to one side, and distorting the face. This will disappear in a few years without special care, and it is helpful to rest and provide a quiet environment. For adults, stabilizers or psychotherapy can help by relieving tension, but the habit spasm can convert into tic.
. Facial Seizure
Spasms in other parts of the body commonly accompany this condition and can be distinguished with electroencephalography.
Dystonia is a condition where the body or the muscles of the limbs contract abnormally and it indicates symptoms of abnormal postures for a lengthy period of time. In cases where it must be differentiated from hemifacial spasm, there are oromandibular dystonia and drug-induced dystonia.
- Oromandibular Dystonia
It is a condition where blepharospasm, which causes involuntary exertion of stress on the eye for a long period of time and closes the eye, accompanies dystonia of the muscles of the mouth, tongue, and jaw. It is most common in women and patients in their 50s. The gaping of the jaw, puckering of the lips, contraction of the platysma, and sticking out the tongue are the most common symptoms. Botulinum toxin injections or other medications such as phenothiazine are used to treat this condition.
- Drug-induced Dystonia
Psychotropic medications can cause acute abnormal dystonia mostly around the facial and cervical area. It can also cause oculogyric crisis where the eye can deviate upward. Anticholinergic medication is used as treatment.
. Tics and Habit spasm
Many people develop habitual actions during their life. If nervous, simple and unique habits such as sniffling, making nonsense sounds, protruding the jaw, and repeating actions such as blinking can all occur. The characteristic of these conditions is that while repeating the same actions, they cannot be restrained. The patient can temporarily restrain the actions after learning that the actions are being done to relieve stress, but the minute the patient turns their thoughts, they reappear. In some cases tics become so habitual that the patient cannot easily recognize them and it appears that the patient cannot restrain them at all.
The interesting thing is that many tics are normal, intentional actions that blend in well and are observable in individuals. What determines a habitual action or a tic is that it is an endless repetitive action that can be one simple movement (for example, blinking, sniffling, and stretching of the neck) to various complex movements.
Habit spasm occur commonly in children from 5~10. This can refer to blinking, shrugging the shoulders, sniffling, tilting the head or the eyes to one side, and distorting the face. This will disappear in a few years without special care, and it is helpful to rest and provide a quiet environment. For adults, stabilizers or psychotherapy can help by relieving tension, but the habit spasm can convert into tic.
. Facial Seizure
Spasms in other parts of the body commonly accompany this condition and can be distinguished with electroencephalography.
