Q: I was diagnosed to have Bells Palsy on the right side of my face associated with Herpes, 1.5 years back. I consulted local doctors and they advised me to take Prednisolone and Acyclovir. Recovery has been 90% till date. For the last 5 months, I have been experiencing twitching in my left eye. My doctor has diagnosed it as hemifacial spasm and has asked me to take Rivotril 0.5mg for 3 weeks. There was no improvement after that. I dont know what to do now! I have also tried homeopathic medicines but again to no effect. I dont know whether this twitching in the eye is a result of Bells Palsy or is it another disease? I would like you to suggest the line of treatment I should follow now.

A:Hemifacial spasm may occur due to partially recovered Bells palsy or may occur due to a vessel pressing on the nerve. I would advise an increased dose of Rivotril 2mg tab ½ tab twice a day and see. If this does not help there is an injection Botulinium toxin which is injected around the eye which is twitching. This helps definitely. The problem is it costs Rs. 5000/- to 8000/- and may have to be repeated every 6-8 months. It is usually given by a neurologist. I would first try Rivotril and see.