Long-term “eyelid jumping” may be a disease
Hemifacial spasm is a clinically common slowly progressive peripheral nerve disease, mainly manifested as involuntary twitching of one side of the face, mostly limited to one side, so it is also called hemifacial spasm. Current studies have confirmed that 80% to 90% of hemifacial spasms are caused by vascular compression in the area where the facial nerve exits the brainstem. A large number of clinical data show that the inferior anterior cerebellar artery and inferior posterior cerebellar artery are the main vascular factors leading to hemifacial spasm, while the superior cerebellar artery is less common. In addition, the superior labyrinthine artery and other abnormal large arteries such as vertebral artery and basilar artery may also form compression on the facial nerve. In addition, non-vascular space-occupying lesions in the cerebellopontine angle area, such as granulomas, tumors, and cysts, can also cause hemifacial spasm.
At the beginning of the course of the disease, it is mostly paroxysmal involuntary twitching of the orbicularis oculi muscle on one side, and gradually develops to the orbicularis oris muscle and other facial muscles on the same side. Affected, bilateral spasms are rare. The degree of convulsions varies from severe to severe. It is paroxysmal, fast and irregular. It is mild at first and lasts for only a few seconds, and then gradually extends to several minutes or even longer, and the intermission period gradually shortens. It can cause difficulty in opening the eyes on the same side, the eye fissure becomes smaller and affects vision, and the corner of the mouth is skewed to the same side and affects speech. It is often aggravated by factors such as fatigue and mental stress, but it cannot imitate or control its onset by itself, which makes people upset Chaos, unable to work or study normally, seriously affecting physical and mental health. In addition, a small number of patients may be accompanied by mild facial pain during convulsions, and in individual cases, headaches and tinnitus on the same side may also occur. Examination of the nervous system showed no positive signs except paroxysmal facial muscle twitching. Only a small number of patients may be accompanied by mild paralysis of the affected side muscles in the late course of the disease.
Many people often confuse hemifacial spasm with facial paralysis, but there is a big difference between the two. Facial paralysis is a motor dysfunction of facial expression muscles caused by damage to the facial nerve due to various reasons. There may be disappearance of forehead lines on the affected side, incomplete eyelid closure, shallow nasolabial folds, deviation of the corners of the mouth to the healthy side, and air leakage when the cheeks are bulging, etc. Manifestations: Hemifacial spasm is a facial muscle clonic twitch caused by abnormal discharge after the root of the facial nerve is compressed and stimulated. Exacerbation of fatigue, mental stress, etc.
Hemifacial spasms will not go away on their own and will only get worse over time, so seek medical attention promptly. At present, only drugs such as carbamazepine and phenytoin may be effective for some mild patients in the short term, and other drugs have no obvious effect, and oral drug treatment cannot be completely cured, and long-term medication is required, and long-term use of these drugs has relatively large side effects. There are also some patients taking neurotrophic drugs such as vitamin B1 and vitamin B12, but with little effect. There are also patients who take local injection of botulinum toxin for treatment. Although it can temporarily relieve the spasm attack to a certain extent, long-term injection will produce drug resistance, and the effect is getting worse. Facial paralysis is theoretically a destructive treatment, and it is not recommended to try it. In addition, patients should not blindly take TCM acupuncture treatment, because the disease itself is caused by abnormal excitement caused by vascular compression and stimulation of the facial nerve. Acupuncture may aggravate the condition instead. Some patients are effective at first, but the symptoms recur in the future and become more serious.
Microvascular decompression surgery is currently internationally recognized by neurosurgery for the treatment of hemifacial spasm with rapid results, significant curative effect, stable recovery, and low recurrence rate. The specific method is to make a small incision of 3 to 4 cm behind the ear, and then separate the blood vessels and nerves to prevent the responsible blood vessels from pressing on the nerves and solve the problem from the root.