Actually you will need a neurosurgeon for choosing the best permanent treatment according to his physical examination. My advice would be according to degree of cases. Mild cases of hemifacial spasm
may be managed with sedation or Carbamazepine
(an anticonvulsant drug). Microsurgical decompression and botulinum toxin injections are the current main treatments used for hemifacial spasm.
For moderate to severe cases we use Microvascular decompression appears to be the most popular surgical treatment
at present. Microvascular decompression relieves pressure on the facial nerve
, which is the cause of most hemifacial spasm cases. Excellent to good results are reported in 80% or with a 10% recurrence rate.
Approximately 10% had previously failed surgery. Side effects include hematoma, swelling, infarction
, and brain death. Botulinum toxin is highly effective in the treatment of hemifacial spasm. It has a success rate equal to that of surgery, but repeated injections may be required every 3 to 6 months. But it is a bit expensive.
Hope the above information helps you. Let me know if I can assist you further.
Dr. Ahmed Aly Hassan