Materiały źródłowe

• #1 Hemifacial Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526108/

  This comprehensive course covers hemifacial spasm (HFS), a neurological disorder characterized by paroxysmal, involuntary twitching of facial muscles on one side of the face, primarily innervated by the ipsilateral facial nerve (seventh cranial nerve). […] Participants get an in-depth exploration of HFS, beginning with its distinctive characteristics, causes, and diagnostic criteria. […] Identify hemifacial spasm’s clinical manifestations and characteristic features for accurate and timely diagnosis. […] Differentiate hemifacial spasm from other facial movement disorders, ensuring a precise understanding of its unique characteristics. […] Diagnosis of HFS is made clinically based on the detailed history coupled with a neurological and local physical examination. Rarely is electrophysiological testing indicated as the diagnosis is made clinically.

• #1 Diagnosing and Treating Hemifacial Spasm | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/hemifacial-spasm/diagnosing-and-treating-hemifacial-spasm

  Hemifacial spasm is usually diagnosed by its symptoms the characteristic tic is the best evidence of the diagnosis. […] An expert evaluation of a patient must include testing for the presence of a tumor or a vascular malformation, or for multiple sclerosis. […] The usual diagnostic imaging tools included magnetic resonance imaging (MRI), computed tomography (CAT scan), or, rarely, angiography (arteriography). […] New FIESTA (fast imaging employing steady-state acquisition) MRI imaging has significantly increased our ability to visualize the offending blood vessel. […] An accurate diagnosis is critical to successful treatment, so Botox injections should not be given until imaging scans and other testing rule out the presence of a tumor or lesion.

• #1 Hemifacial Spasm Treatment Methods and Diagnosis

  https://lonestarneurology.net/neurological-disorders/hemifacial-spasm-treatment-diagnosis/

  A hemifacial spasm is a unilateral involuntary painless contraction of one muscle. It can also affect several groups of facial muscles. Most often, the disorder begins with a twitching of the circular muscle of the eye and passes to half of the face. The diagnosis of hemifacial spasm is simple. The entire half of the face has irregular, uncontrolled contractions. They are usually caused by speech, laughter, or emotional distress. The appearance is so typical that no other methods are necessary to make the diagnosis. But, physicians often prescribe radiological examinations to diagnose. It helps to determine the underlying cause of the compression and treatment. Neurologists use instrumental examinations for hemifacial spasms. First, doctors use MRI in a special mode to treat a hemifacial spasm. This is necessary to rule out vascular and neural conflict in the brains structures.

• #1 Hemifacial spasm | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hemifacial-spasm?lang=us

  Hemifacial spasm is characterized by episodic facial spasms due to irritation of the facial nerve (CN VII). […] Lifting of the ipsilateral eyebrow with eye closure during the spasm, known as the Babinski-2 sign, is highly specific and sensitive for the condition. […] Hemifacial spasm should be distinguished from myokymia a fine undulating fascicular tremor of facial musculature. […] Management options include botulinum toxin therapy: treatment of choice, given three-monthly, with improvement noted in 75-100% of cases. […] Surgical microvascular decompression: generally reserved for cases refractory to botulinum toxin therapy, can result in up to 90% complete and immediate resolution of symptoms.

• #1 Hemifacial Spasms – Facial Pain AssociationIcon / Teal / print@1xicon-heart@1xicon-plane

  https://www.facepain.org/understanding-facial-pain/diagnosis/hemifacial-spasms/

  Hemifacial spasm (HFS) is a condition characterized by painless twitching of the muscles on one side of the face. The contractions are involuntary and occur in a “tonic-clonic” fashion, meaning the facial muscles either are fully tensed or alternate quickly between being tensed and relaxed. […] A doctor, usually a neurologist or neurosurgeon, can diagnose HFS by taking a detailed history of the patient’s symptoms. Sometimes, physicians may perform maneuvers that can trigger the repetitive facial spasms. Other tools to help diagnose hemifacial spasm are electromyography (EMG) and MRI of the brain. An EMG has a specific pattern that may indicate damage to the nerve, and an MRI scan can show if a blood vessel or other mass is compressing the facial nerve. While an MRI or EMG can help confirm the cause of HFS, these tests are not needed for a doctor to diagnose the condition.

• #1 Facial Spasms – Saratoga Ophthalmology

  https://saratoga-ophthalmology.com/facial-spasms/

  Hemifacial spasm can be caused by injury to the facial nerve, a tumor or blood vessel compressing the nerve, or Bells palsy. […] Due to possible compression on the facial nerve causing hemifacial spasm, unlike bilateral essential blepharospasm, which has no known etiology and does not require an imaging study, MRI/MRA or CT/CTA is commonly obtained for people with hemifacial spasm. […] Hemifacial spasm is an involuntary twitching of the facial muscles, usually affecting the entire one side of face and not just the eyelids. […] In contrast to benign essential blepharospasm, hemifacial spasm affects only one half of the face and does not progress to the other side. […] In 92% of cases, the spasm starts near the eye and progresses down the face over time. […] The twitching is usually not painful, but it can be embarrassing and interfere with normal expression and vision.

• #1 Mayo Clinic Health Library – Hemifacial spasm | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20373287

  Diagnosing hemifacial spasm might involve a physical exam. Imaging tests might find the cause of the condition. […] MRI uses a magnetic field and radio waves to create detailed images of the head. This can help find the cause of hemifacial spasm. A contrast dye put into a blood vessel can show whether a blood vessel is touching the facial nerve. This is called magnetic resonance angiogram. […] Diagnosing hemifacial spasm doesn’t always need an MRI scan or other imaging test. Imaging tests might be for people whose symptoms aren’t typical or who are having surgery.

• #1 Hemifacial spasm – Wikipedia

  https://en.wikipedia.org/wiki/Hemifacial_spasm

  Hemifacial spasm (HFS) is a rare neuromuscular disease characterized by irregular, involuntary muscle contractions (spasms) on one side (hemi-) of the face (-facial). […] Diagnosis begins with a complete neurological exam, including an electromyography (EMG: a test that measures and records electrical activity generated in muscle at rest and in response to muscle contraction), magnetic resonance imaging (MRI: a test that uses magnetic waves to make pictures of structures inside the head), computed tomography (CT scan: a type of x-ray that uses a computer to make pictures of structures inside the head), and angiography (an x-ray exam of the blood vessels when they are filled with a contrast material). […] Studies have shown that the most effective method of hemifacial spasm screening is MRI. In one study, only 25% of the CT scans showed the abnormality in hemifacial spasm patients, whilst more than half of the MRI imaging demonstrated a vascular anomaly. MRI imaging is recommended as the initial screening procedure in the assessment of patients with hemifacial spasm.

• #1 Hemifacial Spasm Treatment | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/dystonia/hemifacial-spasm/

  Hemifacial spasm is a clinical diagnosis based on an examination of the movements of the face. […] MRI of the brain is obtained with thin cuts through the brainstem where the 7th cranial nerve runs, as well as an MRA (non-invasive angiogram) of the arteries of the brain.

• #1 Diagnosing Hemifacial Spasm | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/hemifacial-spasm/types/diagnosing

  Another diagnostic test your doctor might use is magnetic resonance imaging (MRI) of the brain. MRI can help identify any structural abnormalities that might be causing the compression or irritation of the facial nerve, which is the underlying cause of hemifacial spasm. […] Note that not all patients with hemifacial spasm will have any visible abnormality, and in some cases, the cause of the spasms cannot be identified with imaging studies. […] Diagnosing hemifacial spasm involves a comprehensive history and physical examination and an imaging test such as an MRI. […] The symptoms of hemifacial spasm can overlap with those of other movement disorders of the face. […] If you or a loved one has been diagnosed with hemifacial spasm, seek an experienced neurosurgeon for appropriate treatment and management.

• #1 Hemifacial Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526108/

  Accurate diagnosis is important as many conditions can mimic HFS. […] The primary treatment goal for HFS is to reduce the muscle contractions resulting from abnormal impulse transmissions to adjacent neurons (ephaptic transmission). […] The advent of botulinum neurotoxin (botox) has revolutionized managing HFS. […] The diagnosis is usually clinically based on a patient’s history and physical exam. EMG and magnetic resonance imaging are conducted to identify or rule out the underlying cause before planning the treatment.

• #1 Hemifacial Spasm Workup: Approach Considerations, Imaging and Other Studies, Laboratory Studies

  https://emedicine.medscape.com/article/1170722-workup

  Early cases of hemifacial spasm may be difficult to distinguish from facial myokymia, tics, or myoclonus originating in the cortex or brainstem. Neurophysiologic testing can be invaluable. […] Spread and variable synkinesis on blink reflex testing and high-frequency discharges on electromyography (EMG) with appropriate clinical findings are diagnostic. Stimulation of one branch of the facial nerve may spread and elicit a response in a muscle supplied by a different branch. Synkinesis is not present in essential blepharospasm, dystonia, or seizures. Needle EMG shows irregular, brief, high-frequency bursts (150-400 Hz) of motor unit potentials, which correlate with clinically observed facial movements. […] Magnetic resonance imaging (MRI) is the imaging study of choice, especially if an underlying compressive lesion is suspected. Cerebral angiography offers little diagnostic value in hemifacial spasm. Ectatic blood vessels rarely are identified, and it is difficult to correlate vessels with the facial nerve. […] There are no known biological markers for hemifacial spasm.

• #1 Hemifacial Spasm | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22719

  Diagnosis of HFS is made clinically based on the detailed history coupled with a neurological and local physical examination. […] Rarely is electrophysiological testing indicated as the diagnosis is made clinically. An electromyogram can be used in the early stages of the disease when it is difficult to distinguish clinically from facial myokymia, blepharospasm, complex partial motor seizures, or motor tics. […] The diagnostic finding on electrophysiological testing is lateral spread and variable synkinesis on blink reflex testing. […] Accurate diagnosis is important as many conditions can mimic HFS. […] A brain magnetic resonance imaging scan is the best diagnostic study to rule out structural causes that may need surgical therapy or lesions indicating multiple sclerosis. […] In most cases of primary HFS, the computerized tomography and magnetic resonance angiography scans report will be unremarkable because a vascular loop lying close to the facial nerve is commonly found even in individuals without HFS. […] Following the first year after surgery, the average success rate of microvascular decompression surgery is reported to be 80% to 88%.

• #1 Differential Diagnosis Between Functional Facial Spasm and Hemifacial Spasm: Role of Blink Reflex – MDS Abstracts

  https://www.mdsabstracts.org/abstract/differential-diagnosis-between-functional-facial-spasm-and-hemifacial-spasm-role-of-blink-reflex/

  Differential Diagnosis Between Functional Facial Spasm and Hemifacial Spasm: Role of Blink Reflex […] Objective: We aimed to test the value of Blink Reflex (BR) as an electrophysiological tool in differentiating functional facial spasm (F-FS) from hemifacial spasm (HFS). […] Background: Diagnosis between F-FS and HFS may be challenging despite a few clinical distinguishing features are supportive of F-FS diagnosis. Blink reflex (BR) is a valid tool for the diagnosis of HFS as well as for understanding the underlying pathophysiology. One of the classic features of HFS is spread of the BR to muscles other than the orbicularis oculi. These early response in lower facial muscles are named R1-like responses because of the resemblance to the R1 response recorded in the orbicularis oculi. R1-like responses in lower facial muscles are likely due to ephaptic responses in the facial nerve after antidromic activation of facial nerve axon terminals by the electrical stimulus at the supraorbital region.

• #1 The many faces of hemifacial spasm: differential diagnosis of unilateral facial spasms – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21469208/

  Hemifacial spasm is defined as unilateral, involuntary, irregular clonic or tonic movement of muscles innervated by the seventh cranial nerve. […] The primary purpose of this review is to draw attention to the marked heterogeneity of unilateral facial spasms and to focus on clinical characteristics of mimickers of hemifacial spasm and on atypical presentations of nonvascular cases. […] Among 215 patients referred for evaluation of hemifacial spasm, 133 (62%) were classified as primary or idiopathic hemifacial spasm (presumably caused by vascular compression of the ipsilateral facial nerve), and 4 (2%) had hereditary hemifacial spasm. […] Secondary causes were found in 40 patients (19%) and included Bell’s palsy (n=23, 11%), facial nerve injury (n=13, 6%), demyelination (n=2), and brain vascular insults (n=2). […] We concluded that although most cases of hemifacial spasm are idiopathic and probably caused by vascular compression of the facial nerve, other etiologies should be considered in the differential diagnosis, particularly if there are atypical features.

• #1 Hemifacial Spasm – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/neuro-ophthalmologic-and-cranial-nerve-disorders/hemifacial-spasm

  Hemifacial spasm refers to unilateral painless, synchronous contractions of facial muscles due to repetitive involuntary electrical impulses from the 7th cranial (facial) nerve and/or its motor nucleus. […] The pulsating blood vessel is often visible on MRI, but diagnosis of hemifacial spasm is ultimately clinical. […] Focal seizures, blepharospasm, and tics cause similar symptoms and should be considered.

• #1 Hemifacial spasm: Types, symptoms, and causes

  https://www.medicalnewstoday.com/articles/319591

  Facial tics are the key sign of hemifacial spasm. Doctors will observe the person and take a medical history, noting how severe the twitches are and how long the person has had them. […] The doctor will then use medical imaging tests to find out what is irritating the facial nerve and rule out the possibility of tumors or brain lesions being the cause. These tests may include: magnetic resource imaging (MRI), computed tomography (CT scan), angiography (arteriography). […] If imaging tests do not find tumors or lesions, doctors will likely assume that pressure from a blood vessel is causing the hemifacial spasm. These tests cannot always locate the blood vessel that is irritating the facial nerve, however, because the blood vessels are so small. […] A hemifacial spasm can be confused with other movement disorders that affect the face. These include facial nerve tics and eyelid spasms. These two conditions affect different areas of the face, and not just one side, which helps doctors accurately diagnose this condition.

• #1 Clinical Symptoms and Differential Diagnosis of Hemifacial Spasm | SpringerLink

  https://link.springer.com/chapter/10.1007/978-981-15-5417-9_5

  Hemifacial spasm (HFS) is characterized by brief, repetitive, and involuntary tonicclonic contraction of unilateral facial expression muscles. The diagnosis of HFS should be made based on the clinical history and typical symptoms of the disease. […] The presence of the other Babinski sign and synchronous contraction of the upper and lower facial muscles are considered specific to HFS. And the absence of red-flag signs of HFS, provocation maneuvers, and taking home videos are useful to facilitate precise initial diagnosis. In this chapter, we reviewed the clinical features and the differential diagnoses of HFS to ensure a precise diagnosis.

• #1 Hemifacial Spasm Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/hemifacial-spasm/types/overview

  Hemifacial spasm is the twitching of these muscles for facial expressions, usually on only one side of the face. […] Hemifacial spasm tends to be a commonly misdiagnosed condition, with the average patient experiencing symptoms for around 8 years before receiving the correct diagnosis. […] If you feel symptoms of hemifacial spasm, it is important to visit a doctor, who can help determine the correct diagnosis. […] Most people with hemifacial spasm will have a blood vessel pressing on the facial nerve; on rare occasion, the cause will be found to be a brain tumor. […] The diagnosis of hemifacial spasm requires a high degree of clinical suspicion, so it is important to visit a neurosurgeon with considerable experience in the field. […] It is important to get a formal assessment by a neurosurgeon to identify the cause and differentiate it from other similar conditions. This will allow early diagnosis and treatment while avoiding the side effects of the treatment.

• #1

  https://www.scielo.br/j/anp/a/JchcnXwmH8WDHYdJYMvHjqx/

  Primary hemifacial spasm (HFS) is characterized by irregular and involuntary contraction of the muscles innervated by the ipsilateral facial nerve. […] None of the patients had a correct diagnosis in their primary care evaluation. […] Despite its relatively straightforward diagnosis, all patients had an incorrect diagnosis and treatment on their first evaluation. […] HFS is highly detrimental to social functioning and QoL and the condition is easily investigated and treated. […] The diagnosis of HFS is imminently based on clinical grounds. […] A significant proportion of our patients not even received a single diagnostic hypothesis in 43.9% of patients, referring them to the tertiary center for investigation of facial movements. […] Even though psychiatric symptoms, such as obsessive and compulsive symptoms, have been described in a Brazilian series of HFS patients, a psychogenic etiology was not found in any of our patients. […] Misdiagnosis leads to a direct impact in QoL, social distress and impairment in activities of daily living such as driving or reading. […] Although HFS is not a life-threatening condition, it brings significant social and physical impairment that is greatly prolonged by an incorrect diagnosis.

• #1 Hemifacial Spasm | Diagnosis and Treatment

  https://nashvillehemifacialspasm.com/hemifacial-spasm-diagnosis-and-treatment/

  Hemifacial spasm diagnosis […] Physicians diagnose hemifacial spasm after discussing symptoms and ruling out any related conditions. Diagnosis should be made by a trained specialist. Neurosurgeons who specialize in the care and treatment of neuromuscular disorders may use imaging studies to diagnose hemifacial spasm and rule out other conditions. For example, they may use magnetic resonance imaging (MRI) to rule out tumors, blepharospasm, dystonia, seizures and other related conditions. Imaging tests are also useful in determining which blood vessel is compressing the facial nerve. […] Unfortunately, some hemifacial spasm patients are misdiagnosed. Because hemifacial spasm is so rare, many patients receive misdiagnoses from medical providers or receive treatment for related conditions, such as Bells Palsy. Other rare disorders, such as trigeminal neuralgia, have similar symptoms and are also commonly misdiagnosed.

• #1 Hemifacial Spasm Treatment Methods and Diagnosis

  https://lonestarneurology.net/neurological-disorders/hemifacial-spasm-treatment-diagnosis/

  Usually, the universal hemifacial spasm diagnosis sequence is: Neurological examination and interview of the patient; MR angiography; CT (computed tomography); ENMG (electroneuromyography). […] After all, they can cause pathological processes in the cerebral cortex or the brain stem. In such cases, the most valuable diagnostic method is neurophysiological testing. […] There are several criteria for hemifacial spasm diagnosis with corresponding clinical manifestations: broad and variable synkinesis in the blink test; high-frequency discharges on electromyography (EMG). […] Magnetic resonance imaging is the diagnostic method of choice. MRI is appropriate when physicians need to rule out compression in a hemifacial spasm. Cerebral angiography is usually ineffective in diagnosing hemifacial spasms. Ectasized blood vessels are rarely detected. And these vascular findings can be difficult to correlate with nerve exposure. Neurologists perform angiography and magnetic resonance. But angiography is usually used for surgical, vascular decompression.

• #1 Hemifacial spasm is not affected by state of consciousness: a case report | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-021-00616-5

  One important diagnostic clue of HFS is called the Babinski-2 sign, the other Babinski sign or brow lift sign and was firstly described by Babinski in 1905. […] While the sensitivity is 86%, the specificity is nearly 100% for HFS, and among trained professionals, there is a high consensus in identification of this sign which cannot be voluntarily reproduced by an individual. […] In addition, as we have reported, symptoms of HFS persist in patients with disturbances of consciousness. […] For the layperson, it is crucial to seek a multidisciplinary consultation to differentiate the diagnosis of focal cortical epilepsy involving the face and to obtain a correct diagnosis. […] In patients with isolated facial movements of unknown or unclear etiology, EEG and multidisciplinary consultation should be strongly considered in the event of diagnostic confusion.

• #1 Treatment Options For Hemifacial Spasms – Associates in Neurology

  https://www.ainpc.com/2021/08/27/treatment-options-for-hemifacial-spasms/

  Hemifacial spasms may develop from excessive pressure on nerves due to a tumor or a bulging blood vessel. For some, there isn’t a definitive cause. Fortunately, Botox injections, medications, and decompression procedures can help with this neuromuscular condition. […] Here at Associates in Neurology, we have state-of-the-art equipment for the proper diagnosis and treatment of neurological conditions. Our team of highly skilled neurologists can perform a thorough assessment of your condition and craft an effective treatment plan.

• #1 Hemifacial spasm is not affected by state of consciousness: a case report | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-021-00616-5

  HFS can be treated surgically or with oral medications, such as benzodiazepines, baclofen, and anticonvulsants if possible, but botulinum toxin injections are generally considered to be the treatment of first choice. […] Herein symptoms of HFS were not life-threatening and anticonvulsants were unnecessary. […] In this case, we have demonstrated the presentation of HFS in the presence of impaired consciousness, and multidisciplinary consultation made the diagnosis and subsequent treatment appropriate.

• #2 Hemifacial Spasm Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/hemifacial-spasm/types/overview

  Hemifacial spasm is the twitching of these muscles for facial expressions, usually on only one side of the face. […] Hemifacial spasm tends to be a commonly misdiagnosed condition, with the average patient experiencing symptoms for around 8 years before receiving the correct diagnosis. […] If you feel symptoms of hemifacial spasm, it is important to visit a doctor, who can help determine the correct diagnosis. […] Most people with hemifacial spasm will have a blood vessel pressing on the facial nerve; on rare occasion, the cause will be found to be a brain tumor. […] The diagnosis of hemifacial spasm requires a high degree of clinical suspicion, so it is important to visit a neurosurgeon with considerable experience in the field. […] It is important to get a formal assessment by a neurosurgeon to identify the cause and differentiate it from other similar conditions. This will allow early diagnosis and treatment while avoiding the side effects of the treatment.

• #2 Hemifacial Spasm | Baylor Medicine

  https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/hemifacial-spasm

  An experienced neurologist can usually diagnose HFS by simply observing it, and an electrical nerve study known as an EMG is rarely needed. […] If atypical features such as facial numbness or hearing loss are present, then a neuroimaging study, such as an MRI or MRA, may be useful.

• #2 Hemifacial spasm is not affected by state of consciousness: a case report | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-021-00616-5

  One important diagnostic clue of HFS is called the Babinski-2 sign, the other Babinski sign or brow lift sign and was firstly described by Babinski in 1905. […] While the sensitivity is 86%, the specificity is nearly 100% for HFS, and among trained professionals, there is a high consensus in identification of this sign which cannot be voluntarily reproduced by an individual. […] In addition, as we have reported, symptoms of HFS persist in patients with disturbances of consciousness. […] For the layperson, it is crucial to seek a multidisciplinary consultation to differentiate the diagnosis of focal cortical epilepsy involving the face and to obtain a correct diagnosis. […] In patients with isolated facial movements of unknown or unclear etiology, EEG and multidisciplinary consultation should be strongly considered in the event of diagnostic confusion.

• #2 Hemifacial Spasm Symptoms and Treatment | Pacific Facial Pain

  https://www.pacificneuroscienceinstitute.org/facial-pain/conditions/hemifacial-spasm/

  The development of the symptomatic twitching is generally predictable. It initially starts in the eye lid occurring primarily with activity and movement. Eventually the twitching marches down the face through the cheek, jaw and into the neck. […] The twitching becomes uncontrolled and occurs even when the patient is trying to quietly rest the face. In more severe cases the twitching progresses to sustained facial contractures referred to as tonus phenomena. Tonus phenomena behaves like a Charlie horse of the face creating periods where the face becomes locking in place with eyes closed, cheeked contracted and jaw clenched. […] In addition to being painful this can be dangerous as it creates uncontrolled loss of binocular vision by closing one eye. These situations can lead to sudden and unpredictable loss of depth perception and 3-dimensional vision.

• #2 Hemifacial Spasm – EyeWiki

  https://eyewiki.org/Hemifacial_Spasm

  Hemifacial spasm is essentially a clinical diagnosis based on presentation and findings and the absence of a known primary cause. […] Although not regularly performed, an electromyogram (EMG) may be used to confirm diagnosis. Neuroimaging in the form of computed-tomography imaging (CT) – where an MRI is not readily available or ideally magnetic resonance imaging (MRI) of the cerebellopontine angle and along the course of the facial nerve from the brain stem to its exit from the skull base is recommended to rule out a compressive space occupying lesion. […] MRI is non-invasive, and sensitive in detecting vascular abnormalities (such as a dolichoectatic vessel) and potential tumors of the cerebellopontine angle.

• #2 Mayo Clinic Health Library – Hemifacial spasm | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20373287

  Diagnosing hemifacial spasm might involve a physical exam. Imaging tests might find the cause of the condition. […] MRI uses a magnetic field and radio waves to create detailed images of the head. This can help find the cause of hemifacial spasm. A contrast dye put into a blood vessel can show whether a blood vessel is touching the facial nerve. This is called magnetic resonance angiogram. […] Diagnosing hemifacial spasm doesn’t always need an MRI scan or other imaging test. Imaging tests might be for people whose symptoms aren’t typical or who are having surgery.

• #2 Hemifacial Spasm Treatment | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/dystonia/hemifacial-spasm/

  Hemifacial spasm is a clinical diagnosis based on an examination of the movements of the face. […] MRI of the brain is obtained with thin cuts through the brainstem where the 7th cranial nerve runs, as well as an MRA (non-invasive angiogram) of the arteries of the brain.

• #2 Hemifacial Spasm | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22719

  Diagnosis of HFS is made clinically based on the detailed history coupled with a neurological and local physical examination. […] Rarely is electrophysiological testing indicated as the diagnosis is made clinically. An electromyogram can be used in the early stages of the disease when it is difficult to distinguish clinically from facial myokymia, blepharospasm, complex partial motor seizures, or motor tics. […] The diagnostic finding on electrophysiological testing is lateral spread and variable synkinesis on blink reflex testing. […] Accurate diagnosis is important as many conditions can mimic HFS. […] A brain magnetic resonance imaging scan is the best diagnostic study to rule out structural causes that may need surgical therapy or lesions indicating multiple sclerosis. […] In most cases of primary HFS, the computerized tomography and magnetic resonance angiography scans report will be unremarkable because a vascular loop lying close to the facial nerve is commonly found even in individuals without HFS. […] Following the first year after surgery, the average success rate of microvascular decompression surgery is reported to be 80% to 88%.

• #2 Hemifacial Spasm Treatment Methods and Diagnosis

  https://lonestarneurology.net/neurological-disorders/hemifacial-spasm-treatment-diagnosis/

  Usually, the universal hemifacial spasm diagnosis sequence is: Neurological examination and interview of the patient; MR angiography; CT (computed tomography); ENMG (electroneuromyography). […] After all, they can cause pathological processes in the cerebral cortex or the brain stem. In such cases, the most valuable diagnostic method is neurophysiological testing. […] There are several criteria for hemifacial spasm diagnosis with corresponding clinical manifestations: broad and variable synkinesis in the blink test; high-frequency discharges on electromyography (EMG). […] Magnetic resonance imaging is the diagnostic method of choice. MRI is appropriate when physicians need to rule out compression in a hemifacial spasm. Cerebral angiography is usually ineffective in diagnosing hemifacial spasms. Ectasized blood vessels are rarely detected. And these vascular findings can be difficult to correlate with nerve exposure. Neurologists perform angiography and magnetic resonance. But angiography is usually used for surgical, vascular decompression.

• #2 Differential Diagnosis Between Functional Facial Spasm and Hemifacial Spasm: Role of Blink Reflex – MDS Abstracts

  https://www.mdsabstracts.org/abstract/differential-diagnosis-between-functional-facial-spasm-and-hemifacial-spasm-role-of-blink-reflex/

  Method: We included 15 patients with HFS, 8 patients with clinically definite F-FS and 15 healthy controls (HC). BR was obtained by bilateral stimulation of the supraorbital nerve and recording with surface electrodes using 4 channel recording from the orbicularis oculi (O-OC) and orbicularis oris (O-OR) muscles of both sides. The primary endpoint was to compare the presence of early R1-like response in ipsilateral O-OR in the 3 groups. […] Results: In all subjects (HFS, F-FS, HC), we obtained the expected R1 response in ipsilateral O-OC and the bilateral R2 responses in both O-OC. In HFS, the early R1-like response was recorded in ipsilateral O-OR in all subjects and in both O-OR in 8 subjects. Early R1-like responses in O-OR were recorded neither ipsilaterally nor bilaterally in any of F-FS and HC subjects. […] Conclusion: The findings of this pilot study suggest that BR might be a reliable and valid electrophysiological tool to support the diagnosis of F-FS.

• #2 Facial twitches DDx • LITFL • CCC Differential Diagnosis

  https://litfl.com/facial-twitches-ddx/

  Recurrent facial twitches are most commonly due to hemifacial spasm, but this needs to be distinguished from other causes. […] Hemifacial spasm (most common cause of recurrent facial twitches; peripherally induced, starts with eye then spreads, mild CN7 LMN weakness with slightly closed palpebral fissure)

• #2 Hemifacial Spasm | Diagnosis and Treatment

  https://nashvillehemifacialspasm.com/hemifacial-spasm-diagnosis-and-treatment/

  Hemifacial spasm (twitches or contractions affecting one side of the face) should not be confused with blepharospasm (twitches or contractions affecting both sides of the face). […] Many patients find out about microvascular decompression surgery through their own research online. Hemifacial spasm is rare, and MVD is a highly specialized procedure, so not all referring providers are aware of this life-changing surgical option. Many physicians may prescribe Botox or other options before microvascular decompression because injections or other medications may temporarily ease symptoms. But, because hemifacial spasm is a progressive condition, only surgical treatment can provide permanent relief.

• #2 Understanding Hemi-facial Spasms & Synkinesis

  https://ostrowonline.usc.edu/hemi-facial-spasms/

  Episodic hyperkinetic spastic contractions can affect the unilateral facial muscles. […] When the muscles innervated by the facial nerve undergo a sudden, unilateral, synchronous contraction, this is called hemi-facial spasm. […] The hemi-facial spasm could be secondary to a compression to the facial nerve at the root zone, local demyelination, ephaptic transmission of impulses or hyperexcitability of the facial motor nucleus due to irritation from peripheral lesion of the nerve. […] It may be primary (mainly attributed to vascular compressions of the seventh cranial nerve in the posterior fossa) or secondary to facial nerve or brain stem damage. […] The efficacy of oral medications in hemi-facial spasm is often transient and the drugs most commonly used are anticonvulsants (such as carbamazepine and oxcarbazepine), anticholinergics, baclofen, and clonazepam. […] The standard medical management for HFS is botulinum neurotoxin (BoNT) injections, which provides low-risk but limited symptomatic relief. […] Microvascular decompression (MVP) is an effective curative method for almost all the patients affected with primary HFS.

• #2 Hemifacial Spasm: Symptoms, Treatments, and Causes

  https://www.healthline.com/health/hemifacial-spasm

  Hemifacial spasms happen when the muscles on either the left or right side of your face twitch without warning. This is caused by damage or irritation to the facial nerve, also known as the seventh cranial nerve. […] In some cases, these spasms may indicate that you have an underlying condition or an abnormality in your facial structure. Either of these causes can compress or damage your nerves and make your face muscles twitch. […] Your doctor may not be able to find out the exact cause of your hemifacial spasms. This is known as an idiopathic spasm. […] Hemifacial spasms are often caused by irritation or damage to your facial nerve. They’re commonly caused by a blood vessel pushing on the facial nerve near where the nerve connects to your brain stem. […] An injury to your head or face can also cause hemifacial spasms because of damage or compression of the facial nerve.

• #2 Hemifacial Spasm: Symptoms, Causes & Treatment Options

  https://njbrainspine.com/condition/hemifacial-spasm/

  Hemifacial spasm syndrome results from vascular compression and distortion of the 7th cranial or facial nerve resulting in painless twitching of the muscles of the face, or facial muscle spasms. […] Medical management is the first course of action, together with chemodenvervation achieved by Botulinum Toxin injections. Microvascular decompression is reserved for patients with persistent symptoms despite these treatments.

• #2 Can Hemifacial Spasm Go Away?

  https://www.neurosurgeonsofnewjersey.com/blog/hemifacial-spasm-symptoms-2/

  If youve been living with the symptoms of hemifacial spasm, youve probably wondered time and time again why they wont just disappear. […] The sooner its diagnosed, the quicker you can be on the road to freedom from the embarrassing and debilitating symptoms caused by this condition. […] The first step in being able to effectively treat your hemifacial spasm is to seek out a diagnosis. […] Once you have the definitive diagnosis in-hand, you can start considering the treatment options. […] Its important to keep in mind that Botox injections must be repeated every few months to maintain efficacy and ensure that the symptoms dont return. […] When you opt for MVD surgery, you can expect a nearly complete to complete cessation of hemifacial spasm symptoms. […] Once youve received your diagnosis for hemifacial spasm, you can start to take the steps needed to get your life and your self-confidence back from this treatable condition.

• #2 A Multidisciplinary Approach in the Management of Hemifacial Spasm – The Journal of Medical Optometry (JoMO)

  https://journalofmedicaloptometry.com/volume1-issue1/a-multidisciplinary-approach-in-the-management-of-hemifacial-spasm/

  Patients with hemifacial spasm are often misdiagnosed. Proper diagnosis of hemifacial spasm warrants an MRI revealing: microvascular compression displacing the right 7th cranial nerve at the root exit zone. […] Clinicians should be familiar with hemifacial spasm and MRI studies should be promptly completed to confirm the diagnosis, identify etiology, and initiate appropriate treatment. […] Diagnosis of hemifacial spasm can be challenging. […] Therefore, it is crucial for optometrists to be aware of the differences between hemifacial spasm and its differential diagnoses in order to make an accurate diagnosis and coordinate the appropriate work-up, along with imaging, to determine the underlying etiology. A careful history and a detailed external examination of the patient are essential, but diagnosis is confirmed by MRI of the brain and internal auditory canal evaluating the course and root of the 7th cranial nerve with attention to the pons/cerebellopontine angle.

• #2 A Multidisciplinary Approach in the Management of Hemifacial Spasm – The Journal of Medical Optometry (JoMO)

  https://journalofmedicaloptometry.com/volume1-issue1/a-multidisciplinary-approach-in-the-management-of-hemifacial-spasm/

  An effective method to distinguish between the two types is with MRI. Early and accurate diagnosis allows for facilitation of the appropriate course of management. […] Although hemifacial spasm is most often due to benign microvascular compression, a timely and accurate diagnosis is necessary to rule out ominous causes and coordinate future care.

• #2 Diagnosis and Treatment of Hemifacial Spasm

  https://lonestarneurology.net/others/hemifacial-spasms-treatment/

  Your doctor will examine your face for signs of muscle twitching or spasm. They will also check for any weakness or paralysis in the affected muscles. […] Imaging tests may be ordered to rule out other conditions that could cause similar symptoms. These tests may include magnetic resonance imaging (MRI), computed tomography (CT), or electromyography (EMG). […] To live a full life and not experience discomfort due to spasms in your face, you should go through all the necessary procedures to determine your disease. Thus, a correct diagnosis can provide up to 50% of your treatment success. Indeed, your chances of success from a timely diagnosis can significantly increase. If you think you may have HFS, see your doctor for an evaluation.

• #2 Treatment Options For Hemifacial Spasms – Associates in Neurology

  https://www.ainpc.com/2021/08/27/treatment-options-for-hemifacial-spasms/

  Hemifacial spasms may develop from excessive pressure on nerves due to a tumor or a bulging blood vessel. For some, there isn’t a definitive cause. Fortunately, Botox injections, medications, and decompression procedures can help with this neuromuscular condition. […] Here at Associates in Neurology, we have state-of-the-art equipment for the proper diagnosis and treatment of neurological conditions. Our team of highly skilled neurologists can perform a thorough assessment of your condition and craft an effective treatment plan.

• #3 Hemifacial Spasm (Facial Twitching): A Definitive Guide

  https://kamranaghayev.com/hemifacial-spasm/

  Hemifacial spasm (HFS, also known as tic-convulsive) is an uncontrolled twitching of the facial muscles, usually one side of the face. […] The diagnosis of hemifacial spasm is pretty straightforward for an experienced clinician. The half of the face has irregular, uncontrolled contractions that are usually triggered by speech, laughter, or emotional expressions. The appearance of spasms is typical and unforgettable. […] One of the unique signs observed only in HFS is Babinski sign (AKA the other Babinski sign or brow-lift sign). It constitutes simultaneous elevation of the eyebrow and closure of the eye and is pathognomonic for hemifacial spasm. […] Hemifacial spasm is caused by focal demyelination of the facial nerve at the brainstem level. […] Imaging studies are essential part of the diagnostic process. The most frequent type of HFS is idiopathic one due to neuro-vascular conflict. MRI is usually capable of demonstrating this compression if properly obtained. […] EMG is a very useful tool in hemifacial spasm. There are several pathognomonic EMG signs that can make substantial contributions to the diagnosis. EMG may show cross-talk between fibers and rule out other movement disorders.

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