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The prognosis of methotrexate pills form depends on the cause of the pathology. There is no specific prophylaxis. Prevention of vascular changes that contribute to the emergence of neurovascular conflict includes measures to prevent hypertension and atherosclerosis. Hemifacial spasm (facial hemispasm) - symptoms and treatment.

What is hemifacial spasm (facial hemispasm)? We will analyze the causes of occurrence, diagnosis and methods of treatment in the article of Dr. Maxim Alexandrovich Koshkarev, a neurologist with an experience of 20 years. The most common is primary hemifacial spasm. It occurs when the facial nerve root in the area of exit from the brain stem is compressed by an arterial vessel (anterior or posterior inferior cerebellar arteries, vertebral or basilar arteries, accessory artery). Compression (compression) of the nerve occurs due to the junction of the vessel to the nerve due to their proximity to buy methotrexate.

Pathological processes in the region of the nucleus and the initial part of the facial nerve root can lead to secondary hemifacial spasm. In some diseases, hemifacial spasm may precede the development of facial neuropathy.

Hemifacial spasm is characterized by the recurrence of clinical manifestations, is paroxysmal, i.e., paroxysmal in nature and is manifested by single or serial, short, frequent muscle twitches, most pronounced in the circular muscle of the eyes. Repeating many times, these twitches turn into a tonic spasm (prolonged tension) of the mimic muscles of the affected half of the face, lasting up to several seconds or minutes. In this case, squinting (squinting) of the eye is noted (i.e., the patient cannot see with this eye), pulling the corner of the mouth up, contraction of the muscles of the chin and subcutaneous muscle of the neck.
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Periods free from hyperkinesis usually last no more than a few minutes, while there is no paresis (weakening) of the muscles, disturbance of their electrical excitability, pain. Patients are unable to restrain the twitching of the muscles of the face by an effort of will.

Hemifacial spasm is not characterized by paradoxical kinesias (atypical movements that were inaccessible to the patient and suddenly performed freely and quickly), there are no movements that can interrupt or prevent hyperkinesia. This distinguishes hemifacial spasm from another movement disorder, dystonia, which is characterized by prolonged or frequently repeated muscle contractions. Only sometimes the attack can be interrupted by pressing on the superciliary arch or other part of the face.

The mechanism of development of the disease depends on the cause of hemifacial spasm. It is based on compression or irritation of the structures of the nucleus or the proximal part of the facial nerve by a vessel, other external factor or internal process. That is, the cause is the mechanical effect of a pulsating vessel or other pathological process on the nerve structures.

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The literature describes cases of involvement of other cranial nerves. auditory or trigeminal. The occurrence of one or another clinical form of HPS depends on the level and degree of generic methotrexate 5mg, each patient has an individual clinic.

The diagnostic algorithm for hemifacial spasm consists of several stages. Clinical assessment - identification of hemifacial spasm syndrome and assessment of its clinical characteristics. It is carried out by a neurologist during the examination.

With secondary hemifacial spasms, elimination of the cause will be effective (removal of the tumor, exclusion of aneurysms from the bloodstream, treatment of the underlying disease, etc.). Treatment with the drug should be carried out by specialists (neurologists, neurosurgeons) who are experienced in the diagnosis and treatment of such conditions and have been trained in the treatment. There is no specific prevention. To prevent the disease and to avoid its recurrence, it is necessary to treat background vascular diseases recognized as risk factors for its development - hypertension and atherosclerosis.
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Clonic movements gradually progress to sustained tonic contractions of the muscles involved. Chronic irritation of the facial nerve or nucleus (which is considered the main cause of hemifacial spasm) can occur due to various reasons. The muscles of the face are subject to the same movement disorders as the muscles of the limbs or trunk. Myoclonus, dystonia and other movement disorders manifest as specific syndromes in the facial muscles. A clear understanding of the mechanism of development of disorders allows for the correct diagnosis and selection of adequate treatment.
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Causes of hemifacial spasm include. vascular compression, nerve mass compression, brainstem lesions from stroke or multiple sclerosis, and secondary causes such as trauma or Bell's palsy. Although there are various treatments for craniofacial movement disorders, botulinum toxin-assisted chemodenervation has proven to be very effective in treating these disorders, surpassing both medical and surgical treatment in some cases.
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Irritation of the nucleus of the facial nerve is believed to lead to hyperexcitability of the nucleus, while stimulation of the proximal nerve can lead to epaptic transmission within the facial nerve. This mechanism explains the rhythmic, involuntary myoclonic contractions that are seen in hemifacial spasm.

Compressive lesions (eg, tumor, arteriovenous malformation, Paget's disease) and non-compressive lesions (eg, stroke, multiple sclerosis, basilar meningitis) may present with hemifacial spasm. Most cases of hemifacial spasm, which were previously considered idiopathic, were probably caused by abnormal blood vessels and compression of the facial nerve within the cerebellopontine angle.

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Hemifacial spasm occurs in people of methotrexate races with the same frequency. There is some predominance of this disease in women. Idiopathic hemifacial spasm usually develops in the fifth or sixth decade of life. The development of hemifacial spasm in patients younger than 40 years of age is unusual, and is often a symptom of a neurological disease (eg, multiple sclerosis).

Involuntary facial muscle movements are the only symptom of hemifacial spasm. Fatigue, anxiety, or reading can speed up movement. Spontaneous hemifacial spasm is manifested by facial spasms, which are myoclonic spasms and are similar to get methotrexate pills myoclonuses that can occur in other parts of the body. Post-paralytic hemifacial spasm, such as after Bell's palsy, manifests as facial synkinesis and contracture. There are a number of conditions similar to hemifacial spasm.

Hemispasm of the masticatory muscle is similar to hemifacial spasm and occurs when the motor trigeminal nerve is irritated. This is a rare condition representing segmental myoclonus, and is manifested by unilateral involuntary contractions of the muscles innervated by the trigeminal nerve (masticatory). As with hemifacial spasm, masseter hemifacial spasm is well treated with medication and botulinum toxin. In addition, there is evidence that surgery may be effective in some cases.

Myoclonic movements in the facial muscles can also occur with lesions of the brain or brain stem. They differ from hemifacial spasm in the distribution of abnormal movements (more generalized, possibly bilateral) and may be diagnosed by neurophysiology. Imaging may reveal deeper causes. Central myoclonus responds well to anticonvulsant therapy.
Oromandibular dystonia is a muscular dystonia affecting the lower musculature of the face, predominantly the jaw, pharynx, and tongue. If oromandibular dystonia occurs in combination with blepharospasm, then this is called Mej's syndrome.

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