Hemifacial spasm associated with a mixed benign parotid tumour.

Destée, Alain; Bouchez, B; Pellegrin, P; Warot, P

doi:10.1136/jnnp.48.2.189

Cited by 16 publications

(11 citation statements)

References 17 publications

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“…There are some reports in the ear, nose, and throat literature of HFSs being caused by compression of the extracranial portion of the seventh cranial nerve by hemangiomas and benign parotid tumors. 5,6 There have been no such reports in the neurosurgical field, although neurosurgeons have surely encountered some cases of HFS that are caused by compression located at a distal portion of the seventh cranial nerve instead of at the REZ in the cerebellopontine cistern. In a few reports, it can be assumed that compression of a distal portion of the seventh cranial nerve was present in some cases of HFS, despite not having been clearly described by the authors.…”

Section: Discussionmentioning

confidence: 99%

Hemifacial spasm caused by vascular compression of the distal portion of the facial nerve

Ryu

Yamamoto²,

Sugiyama³

et al. 1998

Journal of Neurosurgery

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It is generally accepted that hemifacial spasm (HFS) and trigeminal neuralgia are caused by compression of the facial nerve (seventh cranial nerve) or the trigeminal nerve (fifth cranial nerve) at the nerve's root exit (or entry) zone (REZ); thus, neurosurgeons generally perform neurovascular decompression at the REZ. Neurosurgeons tend to ignore vascular compression at distal portions of the seventh cranial nerve, even when found incidentally while performing neurovascular decompression at the REZ of that nerve, because compression of distal portions of the seventh cranial nerve has not been regarded as a cause of HFS. Recently the authors treated seven cases of HFS in which compression of the distal portion of the seventh cranial nerve produced symptoms. The anterior inferior cerebellar artery (AICA) was the offending vessel in five of these cases. Great care must be taken not to stretch the internal auditory arteries during manipulation of the AICA because these small arteries are quite vulnerable to surgical manipulation and the patient may experience hearing loss postoperatively. It must be kept in mind that compression of distal portions of the seventh cranial nerve may be responsible for HFS in cases in which neurovascular compression at the REZ is not confirmed intraoperatively and in cases in which neurovascular decompression at the nerve's REZ does not cure HFS. Surgical procedures for decompression of the distal portion of the seventh cranial nerve as well as decompression at the REZ should be performed when a deep vascular groove is noticed at the distal site of compression of the nerve.

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Section: Discussionmentioning

confidence: 99%

Hemifacial spasm caused by vascular compression of the distal portion of the facial nerve

Ryu

Yamamoto²,

Sugiyama³

et al. 1998

Journal of Neurosurgery

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“…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

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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.

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“…There are only three prior reports of HFS secondary to parotid gland tumor. [39][40][41] The direct compression resulting in local ischemic changes has been documented intraoperatively in all three reported cases. Unfortunately, our third patient refused surgical exploration and was lost to follow-up, and the mechanism in our case is uncertain.…”

Section: Discussion (Table 1)mentioning

confidence: 99%

Unusual Causes of Hemifacial Spasm

2001

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Hemifacial spasm (HFS) has been defined as consisting of brief clonic jerking movements of the facial musculature, beginning in the orbicularis oculi with downward spreading to other facial muscles. HFS, perhaps the most common of the abnormal involuntary facial movements, has been classically ascribed to vascular loop compression at the root exit zone of the facial nerve. Causes other than such vascular loops are rare in the medical literature. Here we present three case studies in which the phenomenology of the HFS was atypical in onset and evolution. Using these three patients as introduction to the topic, we reviewed the literature of all cases of HFS with causes other than the vascular loop. In these three cases, HFS was caused by (1) a parotid gland tumor, (2) a cerebellopontine angle meningioma, and (3) an acoustic schwannoma. We also discuss the radiological findings as well as possible differences in the genesis of HFS and phenomenology in such cases and present recommendations on how to evaluate these patients.

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Hemifacial spasm associated with a mixed benign parotid tumour.

Cited by 16 publications

References 17 publications

Hemifacial spasm caused by vascular compression of the distal portion of the facial nerve

Hemifacial spasm caused by vascular compression of the distal portion of the facial nerve

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

Unusual Causes of Hemifacial Spasm

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