Objective: In this study, we evaluated the clinical findings, comorbidities and teratment responses in our HFS patients.

Background: Hemifacial spasm (HFS) is a peripherally induced movement disorder causing tonic or clonic contractions of the facial muscles. Although the disease is considered to have a benign course, it may lead to functional blindness in many patients.

Method: The records of ninety-six HFS patients were reviewed. All patients were treated with recurrent Botulinum toxin (BT) injections. BT was applied whenever they needed, but the minimum interval between two injections was three months.

Results: 56 of the patients were female and 40 were male. Mean age of the study population was 57.7±11.6 years and there was no difference between the groups (p>0.05). Mean disease duration was 4.94±3.42 years and median disease grade was 1. Both parameters did not differ significantly between the groups (p>0.05). Both parameters did not differ significantly between the groups (p>0.05). Proportion of the left sided (50), right  sided (41) or bilateral HFS were similar in both groups (female – 31:22:3 vs. male – 19:19:1) respectively (p>0.05).  Total injection count was 609 and mean injection number was (6.4±7.2) for each patient. There was no gender difference regarding mean injection number (p>0.05) and mean injection interval (p>0.05). Eyelid ptosis  (5/96) and local reaction (5/96) were the most frequent adverse effects  Most of the patients had isolated HFS (85). However, the remaining had some co-morbid conditions such as Parkinson’s disease (1), strabismus (1), migraine (1), HT (1), history of tumor resection from the maxilla (2) and thalamic infarction (1). The disease started after tooth resection at the same side in one patient, and had similar disease history in his brother.

Conclusion: In HFS, medical treatment strategies like anticonvulsant agents or GABAergic drugs are usually ineffective. Local BT injection (orbicularis oculi or other lower facial muscles) is the best symptomatic treatment for primary HFS. Microvascular decompression of the facial nerve root prevents ephaptic transmission and it is the most effective treatment strategy in selected patients.

References: Colosimo C, Bologna M, Lamberti S. et al. 2006, A comparative study of primary and secondary hemifacial spasm, Arch Neurol, vol 63, pp. 441-444

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hemifacial-spasm-and-related-comorbidities/