Minor Procedures/Medical Services

Blepharospasm/Hemifacial Spasm

Blepharospasm is a medical conditional that causes twitching and spasm the muscles around the eyes and possibly the rest of the face. Also called benign essential blepharospasm, symptoms can range from mild twitching of the eyelid muscles to constant eyelid blinking to severe spasm of the facial muscles and inability to open the eyes. The spasms usually occur on both sides of the face and appear to have an almost synchronized pattern. Many patients have difficulty with vision due to constant eyelid spasms and may experience significant physiological stress due their appearance. Very severe cases, called Meige syndrome, can involve the muscles of the throat including those that control the voice.

The cause of blepharospasm is not completely understood. The most accepted theory is that there is a short circuit in a primitive area of the brain called the basal ganglia. This causes misfiring of the nerves that control eyelid and facial movement.

The treatment for Blepharospasm is Neurotoxin (usually Botox or Xeomin) injections. Injections are highly effective with most patients having significant improvement in their quality of life and vision. Most insurance plans will cover Botox or Xeomin injections for the treatment of blepharospasm. Injections are typically quick and can be virtually painless when numbing cream is used. Effects typically start to be seen in a few days and last around 3 months. Injections are then repeated on a 3-4 month cycle and the dose of Botox of Xeomin is adjusted as needed. A surgery called a myoectomy or Anderson procedure is reserved for only he most severe cases that are not responsive to any other treatment.

Hemifacial Spasm

Hemifacial spasm is a disorder in which one side of the face twitches or spasms. This is in contrast to blepharospasm, which is symmetrical on both sides of the face. Hemifacial spasm often is most severe around the eyes, causing difficulty with vision on the involved side. Lower facial spasm may cause difficulty with chewing and biting of the cheek. Like blepharospasm, patients often suffer both functionally and psychologically.

Hemifacial spasm can be caused by anything that irritates the facial nerve. Commonly, a small blood vessel near the base of the brain will come in contact with the facial nerve and stimulate it. However, and MRI should be done to make sure a brain tumor, malformation, or other structural problem is not the cause.

The treatment for hemifacial spasm is also neurtotoxin (usually Botox or Xeomin) injections. Like blepharospasm treatment, injections are usually quick, relatively painless, and adjusted depending on the extent and strength of the spasm. Injections are repeated every 3 to 4 months.

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