Expressnews
Chennai, February 2025— Hemifacial Spasm (HFS), often referred to as “winking disease,” is a debilitating neurological condition that causes involuntary spasms on one side of the face, significantly impacting a patient’s quality of life. HFS often remains undiagnosed or misdiagnosed for years, as its subtle, progressive nature is frequently mistaken for benign facial tics, stress-induced spasms, or even psychiatric conditions. Even when correctly identified, many physicians focus on symptomatic relief with botulinum toxin, unaware that Microvascular Decompression (MVD) offers a definitive surgical cure. This lack of awareness delays appropriate treatment, leaving many patients to suffer unnecessarily from a condition that can be effectively cured with surgery.
Mr. Sajeeth, a 40-year-old civil engineer and NRI from Riyadh, Saudi Arabia, noticed his eye twitch for the first time 5 years back and initially he ignored as one of the occupational stress and didn’t give too much of thought. But “the twitch” spread from his Left eye to entire face and it became almost constant. When the twitch started affecting his life and confidence, he began his tryst to seek treatment and regain his confidence. He explored various medical options both locally and internationally, consulting experts from top hospitals. Most of the centers misdiagnosed it as a condition which has no treatment, and he was advised to accept and live with this condition.
However, he struggled to find a solution until he came to SIMS, where he was diagnosed as having a hemifacial spasm, a condition in which a blood vessel is touching the facial nerve (cranial nerve VII). The blood pulsating through the vessel irritates the nerve, causing the muscles on one side of the face to twitch. With this diagnosis and a special MRI sequence which confirmed the suspicion of HFS, SIMS Institute of Neurosciences provided him with the permanent cure he had been searching for.
“At one point these spasms took full control of my life in a lot of ways. It made me constantly think about how I look to other people. It got so bad that after some time I was like -Please somebody help me. I met numerous Physicians both in India and abroad and I had almost given up on any cure. But with a chance encounter, I finally found hope at SIMS Hospital. The Institute of Neurosciences at SIMS Hospital not only gave me the treatment I needed but also restored my confidence. I’m forever grateful for their expertise and care.”
— Mr. Sajeeth
SIMS Hospital provides a permanent, life-changing solution for patients suffering from this condition through Microvascular Decompression (MVD) guided by Intra-Operative Neuro-monitoring (IONM).
While MVD is not available everywhere, SIMS stands out with its advanced technology and highly specialized team, ensuring the highest level of precision and safety. Our patient-first approach, combined with cutting-edge neurosurgical expertise, makes SIMS a center of excellence for those seeking lasting relief from Hemifacial Spasm.
HFS typically begins with a subtle eyelid twitch and advances to severe spasms impacting facial muscles. These spasms, with their constant and unpredictable nature, often result in embarrassment, social withdrawal, and, in many instances, depression. People often misdiagnose or overlook the condition, leaving patients with limited treatment options like temporary Botox injections, despite the long-term side effects and its profound impact it has on their lives. Botox becomes less effective with the passage of time.
The cause of HFS is a blood vessel pressing against the facial nerve near the brainstem, leading to involuntary muscle contractions. MVD is a highly effective surgical procedure that provides a permanent solution by relieving pressure on the facial nerve and eliminating spasms at their source. Many patients and even physicians are surprised to learn that the twitching of their eye and face is actually due to an abnormality in the brain.
Unlike other centers, at SIMS Hospital, our skilled Neurosurgeons, Neuroanesthetists, and Neurophysiologists use cutting-edge Advanced Intraoperative Neuro-Monitoring (IONM) signals to guide the completion of this surgery. Microvascular decompression (MVD) performed without intraoperative neurophysiological monitoring (IONM) carries the risk of incomplete decompression, increasing the likelihood of recurrence and failure. The use of IONM has significantly minimized this risk, making surgical failure exceedingly rare. With this cutting-edge technology and specialized care, SIMS Hospital has successfully treated numerous patients, restored their confidence, and improved their overall quality of life.
Dr. Vishwaraj Ratha, Senior Consultant Neurosurgeon at SIMS Hospital, highlighted that hemifacial spasm is frequently misunderstood, leading many patients to suffer unnecessarily due to misdiagnosis or lack of awareness. “As the twitches happen around the eyes and face, it’s very natural for patients to seek help from either ophthalmologists or neurologists. Unfortunately, many healthcare professionals remain unaware of IONM-guided MVD and its high success rate, causing delays in diagnosis and treatment. With IONM-guided MVD, we can offer patients a permanent solution, bringing back their confidence and helping them lead a symptom-free life. This niche surgery with IONM can restore the smile and confidence in patients who have been told that there is no cure. HFS only affects about 1 in 10,000 people. and because these cases are so few and far between, it’s important to have a team that performs microvascular compressions on a regular basis. My skill is not going to be as good if I only do one a year. The more often you do an operation, the more likely that it is going to be successful. It’s like running a race. The more you run, the faster you get, and the more likely you are to win. This condition may not be life threatening, but it can be incredibly disruptive to your life.
SIMS Hospital is committed to increasing awareness among medical practitioners regarding the condition and its potential for a cure, leading to timely referrals and enhanced patient outcomes.”
As part of our HFS awareness campaign, we are also planning to start an HFS support group, where patients suffering from this problem and those who have been cured can discuss challenges, become aware of treatment options, and make more informed decisions.
Dr. Nishanth Sampath, Senior Consultant Neurophysiologist at SIMS Hospital, elaborated further: “Although there are centers in India that provide MVD, unless it’s guided by advanced IONM, the safety and success rate can vary. The presence of a specialized and trained neurophysiologist in the operating room, alongside the neurosurgeon, not only increases safety but drastically improves the outcome. In Mr Sajith’s case, We kept performing the decompression, till the signals of Lateral Spread reflex vanished and that was the end point which we were aiming for. Without IONM, we would have missed the real compression and Sajith would have continued to have HFS and he would have lost trust on an available care. IONM guided MVD restores faith in our discipline”
Dr. Ravi Pachamuthu, Chairman of SIMS Hospital, emphasized the hospital’s commitment to providing advanced, patient-centered care. “The dedicated team focuses on delivering highly effective treatments for neurological conditions like hemifacial spasm, with MVD proving to be a transformative experience for numerous patients. We encourage those affected by this condition to seek timely treatment for a life-changing outcome.”
