Gabapentin as treatment for hemifacial spasm

Hemifacial spasm, a life-long condition characterized by involuntary unilat eral contractions of the facial muscles, is a disabling disorder often resu lting in patient irritation and social embarassment. Its probable etiology is neurovascular compression of the facial nerve at its root exit zone. The current medical treatment consists of either baclofen or anticonvulsant dr ugs, with limitation due to side effects or low efficacy. In recent years b otulinum toxin injection and microvascular decompression of the facial nerv e have been shown to be highly successful. However, both procedures share s ome complications and require special techniques. We present 5 patients aff ected by hemifacial spasm who responded well to the novel anticonvulsant dr ug gabapentin. Gabapentin was administered at a dose ranging from 900 to 1, 600 mg daily, with rapid and clear improvement of spasms and absence of any remarkable adverse effects. Our findings suggest that gabapentin may be an effective treatment for patients with hemifacial spasm with a very good ra tio of therapeutic effects to side effects when compared with other drugs c urrently used.