Hemifacial spasm is a neuromuscular condition characterized by frequent, uncontrolled contractions of muscles on one side of your face. The condition can continue till half of your face appears to “droop.”
Facial twitching usually impacts any one half of the face and the condition is medically described as hemi-facial spasm. The muscles of the face are managed by the 7th cranial nerve, taking a trip from the brainstem, dividing into 5 branches and provides the various muscles of the face situated around the mouth, lips, eyes and eyebrows.
The condition is seen to have a higher frequency in individuals over the age of 40 years. It impacts females more than their male equivalents.
In about 90% cases, the twitching spasm begins with near the eye and advances slowly down to the face. In remaining 10% cases, the twitching starts from chin and advances upwards. In general the condition is pain-free however can be very embarrassing as it disrupts facial expressions and visual disturbances.
Causes of Hemifacial Convulsion
Hemifacial convulsion is generally originated from damage to the facial nerve and manifests itself with symptoms that appear to affect the facial muscles. The commonest causes of hemifacial spasm include damage to the facial nerve.
Facial Nerve Injury can Cause Hemifacial Spasm
Facial nerve exits the skull deep behind the ear area, where it bifurcates into its facial branches. The area lies below the ear and remains in close distance to the base of the skull and the initiation of the cervical spinal column.
This region is exposed and can be frequently at a greater risk of injuries, which can hurt the facial nerve and cause hemifacial spasm. Injuries or trauma to this area can typically take place during sports, due to direct blow over the neck and ear area, or a fall triggering nerve injury.
Car mishaps, rear or front end collisions and whiplash, too can typically cause hemifacial convulsion. In whiplash, the neck might speedily return and front with jerking and the unexpected acceleration and deceleration can cause damage to the structures around the neck and the ear area.
Facial nerve situated in this area can get injured and such injury can cause hemifacial spasm. Other causes of hemifacial convulsion might include brainstem injuries or disorders like stroke or multiple sclerosis, which too can cause facial nerve compression.
Hemifacial Spasm Can be Caused Due to Nerve Compression from Artery
Another common cause of facial nerve compression is a blood vessel near the brainstem, putting in pressure over the facial nerve. The most commonly included blood vessel is a small artery, anterior inferior cerebellar artery, which can compress the facial nerve at the brainstem.
Bell’s Palsy– A Cause of Hemifacial Spasm
Bell’s palsy is a condition, in which the facial nerve gets harmed triggering paralysis of the facial nerve. In this, the control of facial muscles is lost and other functions like taste and development of tears in the eyes are also impacted. As it damages the facial nerve leading to lack of muscle control, it can cause hemifacial convulsions on the afflicted side. It usually impacts one side of the face, nevertheless both sides of the face can be affected.
Tumor Can Cause Hemifacial Spasm
Any sore, growth or growth in the area, through which the facial nerve passes, can compress the facial nerve. This irritates the facial nerve, which too can cause hemifacial convulsion.
While precise causes of hemifacial convulsions may not be known in many cases, it is considered that some kind of irritation of facial nerve typically results in hemifacial convulsion. When no obvious cause of hemifacial spasm is discovered, it may be thought about as idiopathic.
Symptoms of Hemifacial Convulsion
Hemifacial convulsion frequently provides with symptoms that are quickly visible and can be kept in mind by observing the facial motions. Hemifacial convulsion frequently impacts individuals during their middle ages, women being more vulnerable to experience this condition.
Symptoms of hemifacial spasm occurring due to injury can take place at any age, depending upon the cause and intensity of the condition. When hemifacial spasm is experienced in youths, multiple sclerosis might be believed. Generally symptoms of hemifacial spasm are seen on the afflicted side, i.e. the side on which the nerve is inflamed, however in some cases, both sides might show symptoms of facial muscle twitching.
Common symptoms of hemifacial spasm include muscular contractions or twitching muscles of the face, particularly on one side. Muscle twitching and symptoms of hemifacial convulsion, for the most parts, might start around the lower eyelid and slowly reach the muscles of the entire eye.
Muscle twitching may then slowly spread over the lower part of the face, involving the lower lips. Muscles of the cheeks and upper lip are likewise gradually involved. Individuals experiencing hemifacial convulsion often suffer a feeling as if the lower lip is being pulled to one side towards the neck. Ultimately, the centre face may get involved revealing muscle twitching and symptoms of hemifacial pain.
Symptoms of hemifacial convulsion might be worsened by certain triggering factors. These usually include stress, anxiety or sometimes unexpected jerks to the face, head and neck. Overuse of facial muscles like talking, reading, sneezing or yawning are likewise understood to intensify the symptoms of hemifacial spasm.
Depending on the cause of hemifacial spasm and involvement of other areas as when related to other injuries or medical conditions, extra symptoms might be present. Some individuals might experience changes in the sensation over the cheeks, jaws and may often feel a burning sensation.
Sometimes, complaints of tingling and numbness in the face might be noted, depending upon the cause of hemifacial convulsion. Some people might experience dryness of eyes and mouth as associated symptoms of hemifacial convulsion. Individuals who are experiencing hemifacial spasm in a post paralytic scenario, might show symptoms of weakness of facial muscles. This might make facial motions challenging, frowning, smiling and chewing or in some cases swallowing can be hard.
Diagnosis of Hemifacial Convulsion
Diagnosis of hemifacial spasm can be used a combined technique, that includes history taking, medical evaluation and some investigations, as proper. While it is needed to detect hemifacial spasm, it might be hard to distinguish the symptoms of hemifacial convulsion from other associated conditions. In such cases, extra investigations might be thought about to dismiss other possible conditions and confirm any associated medical problems.
Physician takes a total history, which can expose any recent injuries to the head, face or neck area. People involved in sports, or those who have experienced a blow, fall or mishaps have to be questioned about the information of their event.
It is likewise essential to keep in mind the details considering that when the symptoms of hemifacial spasm started and associated symptoms. It might expose any obvious cause of hemifacial convulsion, sometimes. The nature of muscle twitching and the way in which the grievances advanced need to be studied. Any previous injuries, history of surgical treatments or any associated medical conditions are frequently checked.
Medical assessment for the diagnosis of hemifacial convulsion may include inspecting the muscle strength of the facial muscles and their function. The sensory and motor functions of the facial nerve might be studied. Muscle twitching in hemifacial spasm are kept in mind, their pattern and the impacted sides are considered.
Balance of face is studied and the afflicted side is compared with opposite of the face to understand the condition of hemifacial spasm. Different tests might be performed or signs may be elicited by the doctor to examine these aspects. Neurological evaluation and checking for certain reflexes are considered by the doctor to assist the diagnosis of hemifacial convulsion.
Investigations for hemifacial spasm include:
Electromyogram (EMG)– This test helps to study the activity of the facial muscles, when the muscles is at rest and when it is promoted. It can help to identify hemifacial convulsion. When the facial nerve is promoted, it can show pertinent changes and contractions in the facial muscles and the same are tape-recorded. It may be done with nerve studies to find the exact cause of hemifacial convulsion and the participation of the nerve.
Nerve Conduction Study (NCS)– This helps to study the pattern and conduction of signals through the facial nerve, which can help to understand the method which it impacts the facial muscles. Changes in the nerve conduction are tape-recorded, based upon which it is possible to confirm the diagnosis of hemifacial spasm.
Scans– CT scan and MRI of the brain might be thought about, if the possible causes of hemifacial spasm appear to be connected to injuries or conditions of the brain. These scans can help to spot any irregularity of blood vessel, tissue or nerve damage, aneurysm, any growth or tumor in the brain area. If participation of the neck is believed, scans of the neck area might be purchased, as suitable.
Angiogram– If involvement of the blood vessel or compression of the facial nerve due to an artery is thought or to identify an aneurysm. An angiogram might be carried out to validate the diagnosis of hemifacial spasm or to prepare more surgical treatment, in many cases.
Other tests might be required to eliminate other conditions that may appear like hemifacial convulsions. Tests to dismiss stroke, multiple sclerosis, and so on may be considered, if suitable.
Home Remedies To Stop Facial Twitching
There are a large range of alternatives that are offered which include use of anti-convulsant medication or muscle relaxants, use of botox injections or surgery. Nevertheless there are particular natural treatment choices that may be advantageous:
- Reduce the consumption of caffeine and alternatively go with green tea or fresh fruit juices.
- Facial exercises may be handy. Ensure that you get enough good quality sleep every day.
- Magnesium supplements might be helpful in treating the condition. Include magnesium rich foods like peas, beans, seeds, nuts and green veggies like broccoli and spinach in your diet.
- Mild massaging of the face using diluted clove essential oil is very helpful.
- The herb Hyoscyamus is really beneficial in alleviating the symptoms related to twitching. This herb has powerful antispasmodic properties which helps soothe the nerves and avoid twitching.
- Homeopathic drug zincum metallicum is likewise helpful to handle facial twitching. This drug has to be taken two times a day in low effectiveness. Chamomilla, taken in natural potency can also help relieve the nerves and minimize most of the symptoms.
Botox injections are thought about beneficial as they obstruct electrical impulses of the muscles of the face and therefore avoid them from responding to misfired stimuli. Surgery is nevertheless unavoidable if these symptoms of spasms cannot go away.
The procedure is referred to as microvascular decompression, which is focused at decreasing nerve compression. This procedure is carried out by a neurosurgeon, by making a hole in the head and positioning a Teflon sponge in between the compressing blood vessel and the facial nerve.
Medical Management for Hemifacial Spasm
Treatment for hemifacial convulsion consists of medications, injections and in specific cases, which do not respond well to any treatment, surgical alternatives may be considered.
Medications are successfully used for treatment of hemifacial spasm. These include
- Muscles relaxants, which help to relax the overstrained and over stimulated muscles, thus supplying some relief in uncontrolled muscle twitching.
- Anti-convulsant medications are likewise used to treat hemifacial spasm, as these help to obstruct the pain and signals sent out by the inflamed nerve.
- Relaxants and anti-depressants may be given up individuals, who experience anxiety or stress. Medications to handle trauma might be thought about in those experiencing hemifacial spasm due to nerve injury or injury.
Most of these medicines have side effects like dizziness, queasiness, gastric disruptions, and so on. These medications that can supply remedy for hemifacial convulsion need to be taken with physician’s advice and any side effects must be discussed to find a solution.
Physical Therapy – Physical therapy for hemifacial convulsion may be used. It uses methods to unwind tense muscles, reduce discomfort and muscular twitching, which might be thought about, as proper. Electrical nerve stimulation (TENS) and comparable methods that help to relax muscles and alleviate inflamed facial nerve may be thought about.
Nutritional Therapy– Deficiency of particular minerals and vitamins might be associated with the grievances of hemifacial convulsion. In such cases, together with a healthy diet, nutritional supplements may be advised. Magnesium, calcium, iron or other minerals and vitamin B12, folic acid and B complex might help to handle hemifacial spasm in many cases. Minerals and vitamin supplements may be recommended, as suitable in such cases.
Lifestyle Management for Hemifacial Spasm
Lifestyle management of hemifacial convulsion might include use of other techniques in addition to medical treatment.
Counselling – Counselling and psychotherapy can help the mind and body to relax. Routine exercises can help to keep the body fit and stress launching hormones can help to keep the mind calm.
Diet – A diet abundant in whole grains, healthy fats, fresh fruits, vegetables and plenty of water can be handy in handling hemifacial spasm. Drink plenty to water and fluids to preserve electrolyte balance, supply lubrication to joints and keep muscles flexible. Consuming foods rich in minerals like magnesium, calcium, potassium, which are typically discovered in fruits, green veggies, nuts, seeds and beans can be beneficial.
Massage – Gentle facial massage can help to ease the stress in the facial muscles and eliminate hemifacial spasm. Massage oil or face cream can be used on the fingers to make gentle circular motions on the face and the cheeks.
Following particular do’s and do n’ts can help to maintain a healthy lifestyle that can aid the treatment of hemifacial convulsion.
Prevent consumption of stimulants, caffeinated beverages, smoking cigarettes or alcohol (don’t consume alcohol, alcohol is harmful for health), as these can exacerbate nerve inflammation. It is much better to avoid highly skilled foods, heavy preservatives or high fatty foods. Healthy options like milk, green tea, coconut water, fresh vegetables and fruit juices can be consumed rather.
Avoid sitting late night, getting over promoted and even overuse of electronic gizmos, as these too can irritate the nerve and aggravate symptoms of hemifacial convulsion. Make certain you remain relaxed, get a good night’s sleep and feel revitalized on waking up. Setting up a schedule for work and relaxation can help.
Hemifacial convulsion takes place in both males and females, but generally impacts middle-aged and senior women. These convulsions may stem from a compressed facial nerve, which disrupts nervous system signaling.
Tumors, blood vessels and injuries to the face can affect the cranial nerves that innervate facial muscles. Beginning with intermittent eyelid twitching, hemifacial spasms can advance to include the muscles on one side of the face, keeping them constantly contracted. One side of your face might appear to “sag,” similar to Bell’s palsy.
Western medical treatments include surgery, botulinum toxin injections and medications to unwind muscles. Prognosis is dependent on how you respond to treatments; you might have lasting effects for the rest of your life.