Hemifacial spasm (facial hemispasm, Brissot's disease)is a hyperactive syndrome of unilateral facial nerve dysfunction that develops as a result of facial nerve root compression in the area of its exit from the brain stem.
It is characterized by the appearance of moderate and painlessspasms in the circular muscle of the eyes gradually progressing in frequency and strength and spreading down the face involving all the mimic muscles. The attack can take several hours. Muscle contractions are either tonic muscle spasms or clonic convulsions (tic hyperkinesis). As the disease develops on the side of the face appears tonic half mask: the eye gap is more narrow, the mouth and the nose are drawn, platysma is tense. Sometimes the attack is interrupted when pressing on the brow arch or another part of the face.
There are distinguished typical hemifacial spasm (starts in circular muscle of the eye and then captures all underlying mimic muscles of the half of the face) and atypical (starts in cheek muscles and gradually involves the entire overlying mimic muscles). Hemispasm does not spread beyond the area innervated by 7thcranial nerve and may be associated with trigeminal neuralgia. Athemispasm unilateral dysfunction of the auditory nerve is possible (8th cranial nerve).
Methods of treatment
- Microvascular decompression