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Without representing a serious health hazard, HPS significantly worsens the patient's quality of life. The main complications are psychological in nature, associated with the psycho-emotional discomfort experienced by patients due to buy tetracycline online of an aesthetic defect. The disease limits social activity, is an obstacle in professional activity, and can cause depression. In 60% of patients, there is a deterioration in visual function.

Hemifacial spasm is diagnosed by a neurologist according to clinical data. the nature of seizures, the presence of a symptom of synkinesis, the presence of paroxysms during sleep. The absence of other neurological symptoms is important. Hearing impaired patients need to consult an otolaryngologist. In order to confirm the diagnosis, establish the etiology of HPS, additional studies are carried out.

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Two types of myographic patterns characteristic of HPS are described. A pathognomonic sign is the phenomenon of an abnormal muscle response - during electrical stimulation of one of the branches of the facial nerve, a contraction of the muscles innervated by its other branches occurs. MRI of the brain. Allows you to diagnose the cause of root compression. tumor, demyelination focus, vascular malformation, lacuna. According to MRI data, one can judge the primary or secondary nature of HPS. Cerebral MR angiography. Performed in addition to brain MRI to visualize neurovascular conflict.

The detection of the latter depends on the caliber of the conflicting vessel. for large vessels it is 100%, for smaller vessels it is 76%. It is necessary to differentiate HPS from idiopathic blepharospasm, the initial manifestations of which are often unilateral. The main distinguishing feature is the location of the eyebrow during spastic closure of the eyelids. with HPS, the eyebrow is raised, with blepharospasm, it is drawn into the orbit. Differential diagnosis is also carried out with facial myokymia, psychogenic spasm, paroxysms of focal epilepsy.

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It is carried out by antiepileptic drugs (carbamazepine, levetirac, clonazepam), muscle relaxants (baclofen). The long-term results of drug therapy are not well understood and are considered questionable by some authors. Introduction of botulinum toxin. Injections of the drug are made every 3-4 months subcutaneously and intramuscularly in the area of the affected muscle groups. The method is effective in 75% of patients, gives good results when starting therapy in the initial stages of the disease.

It is possible to use conservative and neurosurgical techniques. Conservative therapy is carried out for a long time, and therefore leads to side effects. Neurosurgical treatment allows to radically eliminate the cause of the disease, but does not exclude recurrence.

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It is carried out with neurovascular conflict. The operation consists in separating the nerve trunk and the vessel with a Teflon protector at the point of their contact. The main postoperative complications are dysfunction of the vestibulocochlear nerve (2-3%), facial paresis (3.5-4.8%), often transient. Surgical treatment of aneurysms. It is carried out by clipping the aneurysm neck or its endovascular occlusion. Helps prevent rupture of the thinned vascular wall at the site of protrusion, leading to intracerebral hemorrhage.

Removal of a cerebral tumor. Produced using microsurgical techniques. The volume of the operation depends on the size and type of neoplasm, it is corrected intraoperatively according to the results of histological examination. Hemifacial spasm is characterized by a chronic course. There are cases of spontaneous regression of symptoms, up to 10%. Relapses of the primary form of the disease after microvascular decompression, according to various sources, reach up to 20%.