54-yr-old Yemini national with hemifacial spasm treated successfully at city hospital

Doctors from a city-based hospital treated a 54-year-old Yemini national with a rare brain nerve adhesion. The condition, hemifacial spasm, resulted in a twisted

Doctors from a city-based hospital treated a 54-year-old Yemini national with a rare brain nerve adhesion. The condition, hemifacial spasm, resulted in a twisted face and involuntary twitching since the past 17 years. While treating her, doctors feared that a surgery around the brainstem was risky as any damage could have caused paralysis. However, the surgery was a success giving the patient a new hope at life.

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Speaking about the patient, Dr Pravin Survashe, consultant neurosurgeon with Columbia Asia Hospital, where the patient was treated, said that the patient was suffering from facial spasm. “The facial muscles became stiff over time and so, the patient had a twisted face. For the last two years, the patient had been visiting London to take Botox treatment which did not give her any result even after three to four sessions,” said Dr Survashe.

Dr Bhushan Joshi, the neurologist who diagnosed the patient said that the MRI scan showed a swollen blood vessel on her face which was attached to the artery which was the reason for her condition.

“We took a chance on the basis of clinical judgement and decided to operate. A three-cm size hole was drilled in the skull to perform the surgery which was very high-risk as it takes place around the brainstem and any damage can lead to paralysis or other complications. During the surgery, Dr Survashe separated the nerve from the blood vessel and put a small piece of sponge like material in between so that the blood vessel did not irritate the nerve. This drastically improved her condition. The patient still needs medication, but her condition has improved,” said Dr Joshi.

Dr Survashe added that as a part of the diagnosis, an MRI of her brain was done. Earlier brain MRIs were done, but none showed a loop of blood vessels.

“There was a blood vessel adhesion to the facial nerve in the brain which stimulates the nerve with every pulsation. Medically, such phenomena are known as arachnoid adhesions. That led to sudden twisting of the face. We performed a five-hour-long minimally invasive surgery on her to free the adhesion between the artery and facial nerve. By evening same day, she was able to smile normally,” said Dr Survashe.

Dr Sandeep Borse, neurophysician from Pimple Saudagar said that the surgery is a major one and requires a highly trained surgeon. “The overall complication for this surgery is similar to other neurosurgeries. The frequency of such cases is around nine persons per 1,00,000 population. Such cases are difficult to diagnose by regular doctors however, neurologists may get such patients frequently,” said Dr Borse.

What is Hemifacial spasm?

*Hemifacial spasm is a condition in which one side of the face gets twisted and has involuntary twitching.

*It is a rare nervous system disorder that affects nine people per 1,00,000 in India.

*The treatment is considered difficult as the surgical intervention involves opening the skull.Though it affects both men and women, hemifacial spasm is more common in women over the age of 40.