Facial Spasms

[shari926]

I have been experiencing facial spasms for over 4 years.  I had an MRI approximately 3 years ago, which did not provide a diagnosis.  I have had my magnesium levels checked, but no other tests.  I'm looking for suggestions...

I have had botox injections, although they do help, they leave my face looking unbalanced.  I usually will have a few weeks where I can't close my eye all the way.  

Are there blood test or other test I should be having done?  The Neurologist I am seeing now does not want to do another MRI.

[gigim0385]

Hi, My aunt as a similar problem. I was just curious if your spasms are just on one side of your face?  Also do you have a history of taking any antidepressant drugs?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Hemifacial spasms are spasms of the muscles around the eye which may gradually spread to other muscles on the face or neck. It may be aggravated or induced by action or reflexive facial movements. It is not known what exactly causes this condition (sporadic vs hereditary) but it is believed that is due to demyelination of the seventh cranial nerve likely from nerve root compression. An MRI may show the vascular compromise in the entry region of the nerve that supplies the facial muscles. However, neuroimaging is not routinely performed unless the spasm is atypical or if you are being considered for surgery. Treatment for this condition involve medical therapy with carbamazepine, baclofen or gabapentin; however, botulinum toxin has revolutionized the treatment. (Please note that the injection of BoTox to treat this condition is an art). If you fail these conservative measures, surgery may be appropriate.

If you are wondering what other blood tests could be performed, you may wish to have a calcium level and your thyroid panel checked.

I recommend that you continue working with your neurologist regarding this condition and treatment.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.