Which medications in the drug class Anticonvulsants are used in the treatment of Hemifacial Spasm?

Updated: Sep 16, 2019
  • Author: Steven Gulevich, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Anticonvulsants

Anticonvulsants are used to manage severe muscle spasms and provide analgesia and mild sedation. Anticonvulsants are probably the best medications in terms of efficacy and long-term safety when botulinum toxin and surgery are not options.

Carbamazepine (Tegretol, Equetro, Epitol, Carbatrol)

Carbamazepine (Tegretol) is effective in the treatment of hemifacial spasm and complex partial seizures. It appears to act by reducing polysynaptic responses and blocking posttetanic potentiation. Once a response is attained, attempt to reduce the dose to the minimum effective level or discontinue the drug at least once every 3 months. In patients who cannot tolerate carbamazepine, consider oxcarbazepine (dosage not yet established).

Oxcarbazepine (Trileptal, Oxtellar XR)

Oxcarbazepine (Trileptal) is effective in partial complex epilepsy. It shows promise in hemifacial spasm. Oxcarbazepine may be considered when first-line agents (eg, botulinum toxin, carbamazepine) have failed or are contraindicated.


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