Facial twitching hurts quality of life

By Shahreen Abedin
CNN

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Although she loved the memories they made on vacations together, Sandra Thai regularly threw out a good number of the snapshots of her husband, Dinh.

"She didn't want me to get upset," he explains.

The 37-year old had good reason to be displeased with his photos. Most of them showed the left side of his face contorted -- caught in a persistent twitch that he had had for over three years.

The twitching, better known as a "hemifacial spasm" was a result of two nerves in his brain touching a blood vessel. It's a rare neurological condition affecting less than 1 percent of the population. The more nervous, excited, or embarrassed Dinh would become, the more likely his spasms would appear or intensify.

"It started with the left corner of my eye twitching, so I thought maybe it was from stress," he says. But no amount of relaxation would ease the pulsating. Eventually, the spasms spread to the lower part of his face, and Dinh could no longer ignore it or expect it to just go away.

His family doctor sent him to a neurologist whose MRI scans were inconclusive. Then, he went to an ophthalmologist, who suggested Botox injections to temporarily paralyze the muscles -- a treatment that does often prove effective for mild spasms, but which treats only the symptoms and not the cause. But for Dinh's level of severity, Botox was a bad idea. "It made my cheek all numb and I didn't have control of my cheek or my eye."

In addition to affecting his photos, the twitching would interfere with Dinh's professional and social life. As the owner of a food distribution business in Southern California, he recalls that a simple conversation with a customer would send his face into spasms, shifting the focus to his physical problems instead of the matter at hand. "If I had a meeting, sometimes I just did not want to go."

He also had a hard time seeing, which Dinh says handicapped him during his golf games and made it difficult to focus on more important things, such as spending time with his 4-year old son, William. "I would come home and be so stressed out, I wouldn't want to play with him. I would be too tired."

After three years of searching for a solution, a family friend finally referred Dinh to Beverly Hills, California, neurosurgeon Dr. Hrayr Shahinian of the Skull Base Institute. Using endoscopic technology, Shahinian performed minimally invasive brain surgery on Dinh to disconnect the blood vessel from the nerves. "The procedure is curative and recovery time is a lot shorter than before," says Shahinian. "It is socially complicated condition because you just can't communicate normally."

After the operation, Dinh found that his self-esteem has improved tremendously, as has his desire to be in pictures.

"We are going to take a lot of photos now. You're going to see me smile more, and my wife won't throw them out anymore."

Shahreen Abedin is a producer with CNN Medical News.

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