Treatment of hemilic spasm

Depending on the cause, hemilic spasm can be primary or secondary. In 97% of cases of primary hemilic spasm, the cause is a nearby artery, which pulsates, periodically irritating the nerve, which causes spasm of facial muscles. Secondary hemilic spasm develops due to other diseases or conditions, such as:

• trauma
• Bell’s palsy or idiopathic (of unknown origin) facial paralysis
• brainstem lesions, such as multiple sclerosis, stroke
• arteriovenous anomalies, intracranial arterial aneurysms, arterio-venous fistula, angiomas
• infections of the mammary gland and ear (otitis media, cholesteatoma)
• parotid tumors
• Arnold-Chiari anomaly and other structural anomalies of the posterior cranial fossa.

In the initial stages of primary hemilic spasm, twitching of the circular muscle of the eye is characteristic, possibly even to its involuntary closure. As the disease progresses, the spasm spreads to the lower muscles (circular muscle of the mouth, chin, subcutaneous muscle of the neck). Also, after a long course of the disease, it is possible to form muscle contracture of the affected side of the face, keratitis with the transition to pain in the eye with loss of vision, the formation of saliva from the corner of the mouth with permanent loss of saliva.

The slightest irritation, emotional fluctuations, eating, talking can provoke spasms.

In secondary hemilic spasm, as a rule, twitching occurs immediately in both the upper and lower part of the face.