An unusual cause of hemifacial spasm

Kiley, Michelle; Voyvodic, Frank; Burns, Richard J.

doi:10.1016/s0967-5868(99)90064-4

Cited by 7 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In an experimental animal study by Kuroki and Møller 20) , they showed that close contact between a peripheral branch of the facial nerve and an artery also facilitated the development of an abnormal muscle response, but only if the facial nerve had previously been slightly injured (by a chromic suture) at the location of the arterial contact. Based on the previous reports 1,2,7,8,18,27,28,30,31,34,36) and our results, HFS may be caused along any segment of the facial nerve by a stimulus which can cause injury such as demyelination. The stimulus should be enough to cause demyelination, which may be the reason why arteries are more frequently reported to be an offending vessel than veins or capillaries.…”

Section: Compression Sitessupporting

confidence: 79%

“…Recently, there have been reports that not only the TRZ/CNS but also the other segments of the facial nerve can cause the HFS 8,10,18,28,31,36) . The distal cisternal segment and even the extracranial portion of the facial nerve have been reported to be sites causing HFS 2,7,8,10,18,28,31) . In patients with the HFS, both partial demyelination and axonal degeneration of the seventh cranial nerve may be essential to produce the hyperactivity of the facial motor nucleus.…”

Section: Compression Sitesmentioning

confidence: 99%

See 1 more Smart Citation

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

Park

Chang

Han

2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : We investigated the locations of compressing vessels in hemifacial spasm. To approach compression sites, we described and evaluated the efficacy of the infranuchal infrafloccular (INIF) approach. Methods : A retrospective review of 31 consecutive patients who underwent microvascular decompression (MVD) through INIF with a minimum follow-up of 1 year was performed. Along the intracranial facial nerve, we classified the compression sites into the transitional zone (TRZ), the central nervous system (CNS) segment and the peripheral nervous system (PNS) segment. The INIF approach was used to inspect the CNS segment and the TRZ. Subdural patch graft technique was used in order to achieve watertight dural closure. The cranioplasty was performed using polymethylmethacrylate. The outcome and procedure-related morbidities were evaluated. Results : Twenty-nine patients (93%) showed complete disappearance of spasm. In two patients, the spasm was resolved gradually in 2 and 4 weeks, respectively. Late recurrence was noted in one patient (3%). The TRZ has been identified as the only compression site in 19 cases (61.3%), both the TRZ and CNS segment in 11 (35.5%) and the CNS segment only in 1 (3.2%). There was no patient having a compressing vessel in the PNS segment. Infection as a result of cerebrospinal fluid leak occurred in one patient (3%). Delayed transient facial weakness occurred in one patient. Conclusion : The TRZ and the CNS segment were more vulnerable area to the compression of vessels. We suggest that surgical avenue with the INIF approach provides early identification of this area.

show abstract

Section: Compression Sitessupporting

confidence: 79%

Section: Compression Sitesmentioning

confidence: 99%

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

Park

Chang

Han

2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…Upon literature review, the most common causes of HFS, besides neurovascular compression, were cerebellopontine angle tumors (epidermoid, arachnoid cyst, lipoma, and vestibular schwannoma) 2 , 3 , 9 , 15 , 26 , 38) , and other unusual causes including cerebellopontine angle medullary venous malformations 15 , 24) , Paget's disease 16 , 25) , occipital falcine meningioma 5) , cerebellopontine angle meningioma 11) , acoustic schwannoma 11) , pontine glioma 45) , fourth ventricle ganglioglioma 6) , pontine infarction 43) , syringobulbia 4) , multiple sclerosis 42) , trauma 29) , hypothyroidism 13) , idiopathic intracranial hypertension 37) , vertebrobasilar ectasia 21) , craniovertebral anomalies 28) , glomus jugular tumor 23) , parotid gland 8 , 11 , 12 , 32) , and arterial hypertension 33) . A few cases of HFS alone or in combination with trigeminal neuralgia have been reported as a false localizing sign in patients who had a contralateral posterior fossa mass or acoustic neuroma 30 , 31) .…”

Section: Discussionmentioning

confidence: 99%

A Case of Hemifacial Spasm Caused by an Artery Passing Through the Facial Nerve

Oh¹,

Shim

Park

et al. 2015

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Hemifacial spasm (HFS) is a clinical syndrome characterized by unilateral facial nerve dysfunction. The usual cause involves vascular compression of the seventh cranial nerve, but compression by an artery passing through the facial nerve is very unusual. A 20-year-old man presented with left facial spasm that had persisted for 4 years. Compression of the left facial nerve root exit zone by the anterior inferior cerebellar artery (AICA) was revealed on magnetic resonance angiography. During microvascular decompression surgery, penetration of the distal portion of the facial nerve root exit zone by the AICA was observed. At the penetrating site, the artery was found to have compressed the facial nerve and to be immobilized. The penetrated seventh cranial nerve was longitudinally split about 2 mm. The compressing artery was moved away from the penetrating site and the decompression was secured by inserting Teflon at the operative site. Although the facial spasm disappeared in the immediate postoperative period, the patient continued to show moderate facial weakness. At postoperative 12 months, the facial weakness had improved to a mild degree. Prior to performing microvascular decompression of HFS, surgeons should be aware of a possibility for rare complex anatomy, such as compression by an artery passing through the facial nerve, which cannot be observed by modern imaging techniques.

show abstract

“…A cerebellopontine angle tumor can be identified as a causative factor in only 1 % of all cases with HFS. Meningiomas [3], epidermoid cysts [4 ± 6], lipomas [7,8], pontine gliomas [9], fourth ventricle gangliogliomas [10], glomus jugulare tumors [11], intermediate nerve schwannomas [12], facial schwannomas [13], vestibular schwannomas [14], arachnoid cysts [15] and AVMs [16] are among the reported histopathologies.…”

Section: Discussionmentioning

confidence: 99%

Relief of Hemifacial Spasm after Radiosurgery for Intracanalicular Vestibular Schwannoma

Peker

Özduman

Kılıç

et al. 2004

Minim Invasive Neurosurg

View full text Add to dashboard Cite

Secondary hemifacial spasm due to vestibular schwannoma is very rare. This is the first reported case of hemifacial spasm responsive to gamma knife radiosurgery in a patient with an intracanalicular vestibular schwannoma. Both the resolution of the spasm as well as tumor growth control were achieved with a single session of gamma knife radiosurgery. We report a 49-year-old male patient with a 6-month history of right-sided hearing loss and hemifacial spasm. MR examination revealed an intracanalicular vestibular schwannoma. The patient was treated with radiosurgery and received 13 Gy to the 50 % isodose line. Tumor growth control was achieved and no change in the tumor volume was present at the last follow-up at 22 months. The hemifacial spasm completely resolved after one year. Surgical removal of the presumably causative mass lesion has been reported to be the sole treatment in secondary hemifacial spasm. This case report indicates that it may be responsive to gamma knife radiosurgery. Whether or not this might be a treatment option in selected refractory cases of hemifacial spasm remains to be defined.

show abstract

An unusual cause of hemifacial spasm

Cited by 7 publications

References 16 publications

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

A Case of Hemifacial Spasm Caused by an Artery Passing Through the Facial Nerve

Relief of Hemifacial Spasm after Radiosurgery for Intracanalicular Vestibular Schwannoma

Contact Info

Product

Resources

About