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Botox Injection For Eye and Facial Spasms

Any unusual, uncontrolled muscular contraction around the eye, including blinking, eyelid tics, twitches, as well as difficulty keeping the eyelids open for long periods, is referred to as blepharospasm. There is no cure for this chronic condition. However, many people find relief from their symptoms through surgery, medication and injections. Studies show that approximately 90% of persons that suffer from blepharospasm get complete relief after getting Botox injections. The results have been found to last between 3 and 4 months (Carruthers 1985; Scott 1985; Tsoy 1985; Dutton 1986; Carruthers 1987; Dutton 1994; Poungvarin 1997). 

Hemifacial spasm is a nervous system disorder. It is a neuromuscular disorder that impacts the muscles that are activated by facial nerves. This leads to involuntary twitching on one side (hemi) of the face. The condition is caused mainly by damaged facial nerves that carry signals from the brain to the muscles. It is characterized by involuntary muscle contractions on one side of the face, which causes one side to twitch involuntarily. In some cases, the disorder is caused by blood vessels pulsating or pressing against facial nerves. The condition can also be caused by injuries or a tumour. It may also be caused by fatigue, stress, or anxiety. In some cases, the root cause of involuntary twitching is unknown. 

How is It Diagnosed?

If you suspect you have hemifacial spasms, you need to see a doctor. The doctor will perform a neurological exam. The purpose of the neurological exam is to evaluate brain function. It is not uncommon for your healthcare provider to recommend an MRI (magnetic resonance imaging). The MRI uses magnetic and radio waves to create images of your body. 

The treatment plan used will depend on the results of the diagnosis. Oral medication, surgery, and botulinum toxic A (Botox) injections are the most common treatments available. 

  • Oral medications are usually the first treatment option. It is considered when a patient has mild symptoms. The purpose of the medication is to interrupt electrical signals from the brain that trigger spasms. Carbamazepine, clonazepam and baclofen are the most common oral medication used. The only drawback with medication is that they have some mild to moderate side effects. The side effects include nausea, drowsiness, skin rash and balance problems. 
  • Surgery and Botox injections are mainly recommended for cases where the symptoms are severe. Surgery is mainly recommended when there is a blood vessel that is pressing against a facial nerve, thus causing spasms. MVD (microvascular decompression) surgery may be recommended. With this surgery, the surgeon uses a tiny metal plate to reduce the compression. This helps stop facial spasms. 
  • Botox has proven to be the most effective treatment for hemifacial spasms. A tiny needle is used to inject botulinum toxin around the facial muscles that are affected. The objective is to temporarily weaken the muscles to stop the facial spasms. Most people require repeat injections every three to four months. To guarantee the best results, you must find an experienced doctor to perform the injections. This is because the wrong dosage and injection in the wrong muscles can lead to poor results or side effects.

Treating Hemifacial Spasms with Botox 

Botox injection is the primary treatment for Hemifacial spasms. The condition is treated by injecting Botox (botulinum toxin) into an affected muscle. Most patients respond well to the injections. As a matter of fact, about 95% of patients who get the injections report improvement when treating facial spasms and tics (Wang 1998). There is also evidence that with repeated Botox injections, long-term improvement can be achieved (Jankovic 1993). However, when a blood vessel pulsating or pressing against a nerve is found to be the cause of the disorder, surgery may be required. In this case, a surgeon will make an incision and reposition a blood vessel far from the impacted facial nerve. 

The involuntary muscle movements usually start with an intermittent spasm or tic of an eye muscle. In severe cases, the eye may be forced to shut. Over time, the spasms might spread to the other muscles in your lower face. This may lead to the mouth pulling towards one side. In severe cases, the involuntary spasms can spread, over time, to all the muscles on one side of your face and/or neck. 

The most common symptoms of hemifacial spasms are involuntary twitching or the contracting of muscles on one side of the face. The spasms are uncontrollable and are usually painless. In most cases, the contractions begin in the eyelid and progress to the cheek and mouth. The condition does not affect the whole face but rather one side. The twitching never occurs on both sides of the face at the same time. In the beginning, the spasms might start and stop on their own. After a couple of months or years, the spasms can occur constantly. 

The majority of people that suffer from hemifacial spasms are above the age of 40. In younger people, the condition can, at times, be caused by underlying neurological conditions like multiple sclerosis. Women have a higher risk of suffering from this condition. 

Treatment with Botox 

During treatment using botulinum toxin, a doctor will inject a small amount of the drug into multiple areas of the brows and eyelids. The needle never gets close to the eye. This means you are not in any danger of getting your eye punctured during the procedure. You will not notice the results until after about three days. Most patients notice the full effects of the treatment, more so when it comes to blinking. 

When treating hemifacial spasms, Botox works by slowing the rate as well as the force of blinking. This helps reduce the symptoms both safely and effectively. The results usually last for three to four months. Thereafter, you will need a repeat injection. You can always expect to go home immediately after the treatment since it has very minimal downtime. It is, however, advised against rubbing or massaging the treated area so as not to spread the toxin to other tissues. 

Approved Indications for Botox