What are the symptoms of hemifacial spasm?

Abstract: What are the symptoms of hemifacial spasm? Hemifacial spasm is also a disease that affects everyone's facial health to some extent. After you get sick, you should seek medical advice in time for your health. However, I suggest you know more about what the symptoms are so that you can find them in time. So what are the symptoms of hemifacial spasm? To solve this problem, let's take a concrete look together. What are the symptoms of hemifacial spasm and what is the best treatment for hemifacial spasm?

What are the symptoms of hemifacial spasm?

Typical convulsion, without other positive neurological signs, is generally not difficult to diagnose. Routine EEG and electromyography should be done, and mastoid, skull X-ray, skull CT and MRI should be done when necessary to rule out mastoid and skull diseases. It is characterized by electrical stimulation of the affected supraorbital nerve, contraction of the affected orbicularis oculi muscle and other muscles dominated by facial nerve. Normal people or other diseases stimulate unilateral supraorbital nerve, which only causes contraction of orbicularis oculi muscle dominated by unilateral supraorbital nerve.

The main reason of hemifacial spasm is that the nerve root (REZ) of facial nerve is compressed by arterioles, including anterior inferior cerebellar artery, posterior inferior cerebellar artery and varicose veins. After middle age, these normal and cross-compressed blood vessels begin to harden and blood pressure rises. Long-term nerve compression can cause demyelinating degeneration, leading to crosstalk between nerve axons, and the excitement changes from efferent to afferent, which can accumulate and release a large number of abnormal potentials. Can cause hemifacial spasm. This argument can also be used to explain the causes of trigeminal neuralgia and glossopharyngeal neuralgia. However, in recent years, many scholars hold negative opinions, because many people do not have hemifacial spasm because their facial nerve is compressed by blood vessels, and 20% to 3 1% of hemifacial spasm patients cannot find that their nerves are compressed by blood vessels. In recent years, the author and others determined trace elements in serum and cerebrospinal fluid of 30 patients, and found that serum calcium and magnesium ions in all patients were significantly reduced, indicating that vascular compression demyelination of nerves.

At first, it is a single eyelid pulse, which can gradually spread to the hemifacial muscle from top to bottom, and then seriously affect the neck and shoulder muscles. This involuntary spasm is beyond your control, and emotional tension and excessive fatigue can induce or aggravate the condition. According to the test, this kind of facial muscle discharges synchronously for 350 times per second, which is characterized by closed eyelids and crooked mouth. A twitch lasts for several seconds, and the elderly for several minutes. The duration of the intermission is uncertain, and the patient is upset during the attack. Occasionally, patients with facial pain, nasal congestion and headache do not have seizures during sleep, but there are still 1 1% patients who twitch as usual during sleep, which affects sleep. Seizures are becoming more and more frequent, which seriously affects their lives and work. After a long illness, their muscle strength gradually weakens, and they can develop into hemifacial paralysis in the later stage.

The best treatment for hemifacial spasm

1, drug therapy

After the general diagnosis of hemifacial spasm, patients need to go to the neurology department of a public 3A hospital for drug conditioning under the evaluation of a specialist. Conventional drugs for hemifacial spasm are carbamazepine and phenytoin sodium, but they are effective for mild patients, and patients are prone to drug resistance and side effects after long-term use, so drugs cannot be used as a way to treat hemifacial spasm for a long time.

2, radio frequency temperature control thermocoagulation therapy

According to the above method, stylomastoid foramen was punctured with a radio frequency trocar, and heat energy was generated between nerve fibers by radio based on the principle of electric couple. The temperature is 65-70℃. Under the monitoring of the facial nerve function monitor, the temperature is controlled to make the nerve thermally coagulate, so as to reduce the nerve fibers conducting abnormal impulses. Facial paralysis will also occur after the operation, and the old disease will recur during the gradual recovery of facial paralysis within 1 ~ 2 years. Otherwise, the spasm will not appear for a long time, and it will be replaced by permanent facial paralysis.

3. Botulinum toxin injection therapy

The advantage of treating hemifacial spasm in this way is convenient and quick, and the effect of relieving hemifacial spasm after operation is obvious. However, the effective period of botulinum toxin in the treatment of facial spasm can only last for about 6 months. Repeated injection of botulinum toxin will lead to adverse side effects such as muscle stiffness and facial paralysis.

4. Surgical treatment