How to treat hemifacial spasm?

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Patients: the left eye beat while the mouth to the left beat, 07 years without treatment the following treatmentDepartment of Neurology Hena


Patients: the left eye beat while the mouth to the left beat, 07 years without treatment the following treatment

Department of Neurology Henan Province People's Hospital Feng Zhouqin: hemifacial spasm caused by many reasons, it can be one of the sequelae of facial paralysis, can also be caused by motion of intracranial facial nerve nucleus or facial nerve lesions may also be caused by motor cortex lesions of the limitations of the manifestations of epilepsy. But in most cases can not find what obvious reasons, called idiopathic hemifacial spasm.

Primary hemifacial spasm occurred in adult women, may initially only slight twitching upper and lower eyelids or quarrel, then can be extended to other ipsilateral facial muscles. The most striking of the onset of tic or blepharospasm. Patients in the conversation, the report and other public occasions, the most obvious convulsions. Therefore, every encounter with people, the patient's mood will be due to fear of seizures and become tense, and the more tense, the more obvious seizures, the heavier the burden of mental.

Here are some of the main treatments.

Drug treatment: various sedative and antiepileptic drugs such as diazepam, phenobarbital, phenytoin and diazepam, C Masi Bing on a few patients can relieve symptoms. Chlorzoxazone and muscle relaxant has certain effect.

Physical therapy: using calcium iontophoresis or advection stimulation, can reduce symptoms in some patients. In recent years, the use of radio frequency treatment, the use of radiofrequency thermocoagulation temporary nerve conduction function in the middle section, so that seizures stop seizures, mild facial paralysis after surgery, but generally in 3 to 6 months can be restored.

Ethanol injection therapy: patients who have been treated with the above drugs or physical therapy, and the symptoms are serious, may consider the use of ethanol injection therapy. With different concentrations of ethanol injection on the surface until the nerve conduction function, can make the nerve section temporarily, relieve hemifacial spasm.

Type A botulinum injection therapy: A type botulinum toxin injection in the facial nerve endings, resulting in muscle relaxation paralysis, and to achieve the purpose of relieving spasm. After the injection of spasticity in the short term rapid remission, repeated injection did not find side effects. Microvascular decompression: the operation method is through posterior approach into the skull, the micro blood work piece of gelatin sponge root and nerve root compression of the facial nerve is separated, thereby eliminating the facial nerve vascular compression and stimulation, is a cause for the treatment. Some scholars praised it as a high cure rate, low recurrence rate, safe and effective radical surgery. However, because of the need for craniotomy, the risk of intracranial complications, so most patients are difficult to accept, and its long-term efficacy needs further observation. According to our observation, a considerable number of patients will relapse after 8-12 months. Some patients even relapse after 3 months of surgery. Therefore, taking into account such surgical treatment, should take a very cautious attitude.

Triple injection therapy: This is what we use in the treatment of hemifacial spasm in practice. The main method is according to the specific circumstances of patients, selective and targeted for drug injection to the stylomastoid foramen, anterior auricular point or folds with special method to detect the facial movement point, in order to effectively relieve hemifacial spasm. The advantages of this method are: quick onset, long acting time, easy to use, no pain, patients are willing to accept; local side effects are small, repeated injection of no allergic reaction.

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