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Management of recalcitrant hemi-facial spasm with upper eyelid gold weight insertion

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Abstract

Hemi-facial spasm (HFS) has a presentation of variable severity but is consistently troublesome for the affected individual who can suffer significant social embarrassment from the persistent and unpredictable facial twitching. Here, we present a case of a 62-year-old male with a 17-year history of left hemi-facial spasm secondary to compression of the facial nerve at the root exit zone by an ectatic ipsilateral posterior inferior cerebellar artery. His HFS failed neurosurgical intervention, and medical therapies were found to be ineffective or poorly tolerated. His HFS was noted to be exacerbated on forced eye closure and subsequently it was observed that he was compensating with incomplete eye closure on the affected side. Surgical placement of an upper lid gold weight has significantly diminished the severity and frequency of his HFS symptoms and obviated the need for an orbicularis oculi myectomy.

Level of Evidence: Level V, therapeutic study.

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Authors and Affiliations

  1. Department of Plastic & Reconstructive Surgery, Royal Brisbane & Women’s Hospital, Brisbane, Queensland, Australia

    Henry Beem, Darryl Dunn, Matthew Peters & Kieran Rowe

  2. University of Queensland, Queensland, Australia

    Henry Beem, Matthew Peters & Kieran Rowe

  3. Griffith University, Queensland, Australia

    Henry Beem

Authors
  1. Henry Beem
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  2. Darryl Dunn
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  3. Matthew Peters
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  4. Kieran Rowe
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Corresponding author

Correspondence to Henry Beem.

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For this kind of article, formal consent from a local ethics committee is not required.

Conflict of interest

Henry Beem, Darryl Dunn, Matthew Peters, and Kieran Rowe declare that they have no conflict of interest.

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Patient provided written consent before his inclusion in this study. Additional consent was obtained for the use of his images.

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None.

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Beem, H., Dunn, D., Peters, M. et al. Management of recalcitrant hemi-facial spasm with upper eyelid gold weight insertion. Eur J Plast Surg 40, 483–486 (2017). https://doi.org/10.1007/s00238-017-1294-y

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  • DOI: https://doi.org/10.1007/s00238-017-1294-y

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