While the Jannetta procedure (also known as microvascular decompression or MVD), performed exclusively in western Massachusetts at Baystate Medical Center by Dr. Kamal Kalia, is known primarily for curing trigeminal neuralgia, the innovative surgery can provide relief from other neurological conditions as well.
Just ask Northampton, MA lawyer Susan Cooper, who knows full well the procedure’s additional benefits.
THE TWITCH OF AN EYE
It started back in 2016 with a very small twitch by her eye that no one except Susan noticed. Over time, the twitching increased, to the point that she began to feel as if someone was tugging on the left side of her face. Susan, now age 59, was diagnosed with hemifacial spasm. But it would be five years before she learned that Dr. Kamal Kalia was an expert in performing the Jannetta procedure, which could provide her relief.
“It wasn’t usually painful, but it would keep me up at night. Over time, the twitching became very noticeable and increasingly interfered with my work and social interactions,” said Susan. “I felt the need to explain why I was twitching to everyone I met.”
Hemifacial spasm is a neuromuscular disorder that involves frequent involuntary contractions or spasms of the muscles on one side of the face. The disorder occurs in both men and women, yet it is more common in middle-aged or older women. It is also much more common in the Asian population.
SPASMS SPREAD TO FACE
The first symptom is usually twitching of the eyelid muscle that comes and goes. This can then lead to forced closure of the eye. The spasm may then gradually spread to involve the muscles of the lower face, pulling the mouth to one side. Eventually the spasms involve all of the muscles on one side of the face almost nonstop. Rarely, doctors see individuals with spasm on both sides of the face.
Similar to trigeminal neuralgia, hemifacial spasm is most often caused by a blood vessel pressing on the facial nerve at the place where it exits the brainstem.
Dr. Scott Cooper, a physiatrist at Pioneer Spine & Sports Physicians and Susan’s husband, sent her to his colleague for evaluation. An MRI confirmed that there was no other cause for the spasms.
BOTOX CAN HELP
Her doctor suggested the less invasive option of trying the injection of botulinum toxin, commonly referred to as Botox, into the affected areas, considered to be an effective therapy.
“Botox helped for a while, but it wasn’t perfect. The injections were uncomfortable and caused dryness in my eye. I learned that they could eventually weaken my facial muscles so that they might permanently droop. When the injections stopped working well, I was left with no option other than to consider the Jannetta procedure,” said Susan.
“My husband knew that the Jannetta procedure was performed locally by Dr. Kamal Kalia at Baystate Medical Center. So, a consult was set up with Dr. Kalia at his Springfield office back in the fall of 2021,” she added.
BRAIN SURGERY SUGGESTED
The Baystate neurosurgeon—who trained under the late Dr. Peter Jannetta, inventor of the procedure, at his Pittsburgh clinic—explained to Susan just what the delicate surgery involved. The surgeon makes a small incision behind the ear, drills a hole into the skull to expose the trigeminal nerve, then places a tiny sponge made of Teflon felt between the compressing vessel and the nerve to relieve the pressure.
“I told Dr. Kalia that I would consider the procedure. The thought of brain surgery was terrifying to me,” said Susan.
Susan researched the procedure and had a second consult at Massachusetts General Hospital, with another surgeon who had trained with Dr. Jannetta and who was suggested by Dr. Kalia.
“In the end, I chose Baystate because I had confidence in Dr. Kalia and his team. I believed that I would receive more personal attention and excellent care at Baystate and that I would benefit from being closer to home,” she said.
QUALITY OF LIFE RESTORED
Her quality of life was negatively affected by the almost continual spasms, and Dr. Kalia had inspired great confidence that he could eliminate them. So, Susan had surgery on February 23, 2022.
“It worked right away and when I woke up my face wasn’t twitching anymore. It was pretty amazing. My recovery was excellent. I spent one night in the Intensive Care Unit and one night on a medical surgical unit. Then, I recovered at home for several weeks before returning to work,” said Susan.
GRATEFUL TO DR. KALIA
“I’ve very grateful to Dr. Kalia. He and the hospital staff took wonderful care of me,” she added.
Today, Susan has no residual effects from the surgery, requires no additional follow-up, and is back to her practice of business law, minus the twitching of her eye and the pulling on her face, which before the surgery had become very noticeable to others.
If you are experiencing facial twitching, pain, or burning or tingling sensations, take our free trigeminal neuralgia risk assessment. Our neurology team at Baystate Health is available to discuss your concerns and potential treatments, including the Jannetta procedure.