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Salari M, Alikhani A, Vakili K, Fathi M, Etemadifar M. Primary hemifacial spasm: anatomical insights. Acta Neurol Belg 2024:10.1007/s13760-024-02660-4. [PMID: 39417909 DOI: 10.1007/s13760-024-02660-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 10/11/2024] [Indexed: 10/19/2024]
Abstract
BACKGROUND Primary Hemifacial Spasm (pHFS) is a disorder caused by compression of vessels on the root of the facial nerve. There has been conflicting evidence regarding the side of the face that is more frequently affected. Moreover, it has been found in several studies that women are afflicted by approximately twice as many as men. OBJECTIVES We reviewed the literature to explain HFS tendencies from an anatomical aspect. We wanted to see whether there are anatomical variations that can increase the risk of developing HFS or underlie its tendency to a specific gender and side of the face. METHODS AND MATERIAL A PubMed search was done for the articles on "Hemifacial Spasm" published in English literature, and we selected the articles regarding the significant anatomical differences in HFS patients. RESULTS AICA proximal branching pattern, highly originated PICA, VA dominancy, and VA deviation are among the predisposing anatomical variances. Overall, both sides of the face are equally affected in HFS. However, there are side preferences based on the causative vessels, which may be due to differences in the anatomical features of the left and right side vessels. CONCLUSIONS Various anatomical variations regarding posterior circulation can increase the risk of HFS. Recent evidence suggests whether there is no side dominance or a tendency exists toward the left side. There is no comprehensive explanation for precise reasons underlying the tendency of HFS to affect women. Evidence regarding anatomical variations of the posterior circulation comparing men and women with HFS is scarce, and further studies are required.
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Affiliation(s)
- Mehri Salari
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Alikhani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shohada Tajrish Hospital, Tajrish Square, Tehran, Iran.
| | - Kimia Vakili
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mobina Fathi
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Etemadifar
- Department of Neurosurgery, Isfahan Medical University, Isfahan, Iran
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Wanchun Z, Zhenxing L, Hua Z, Shiting L. Optimized microvascular decompression surgery for improving the results of hemifacial spasm: an analysis of reoperations. Neurosurg Rev 2024; 47:685. [PMID: 39325203 DOI: 10.1007/s10143-024-02892-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 08/04/2024] [Accepted: 09/15/2024] [Indexed: 09/27/2024]
Abstract
Microvascular decompression (MVD) surgery is an effective curative treatment for hemifacial spasm (HFS). This study aims to establish techniques that may lead to favorable outcomes by analyzing reoperations in patients with persistent or recurrent HFS.Patients who exhibited persistent or recurrent HFS symptoms after prior MVD surgery were identified as candidates for reoperation. Information regarding the reoperations was collected by tracing the entire surgical procedures and peri-operative management. Clinical manifestations and follow-up data were obtained from the hospital records and subsequent visits.Twenty-six patients underwent repeat MVD surgery. Among them, multi-culprit neurovascular compression (NVC) was identified as the primary cause of failure to response to the previous operation in 73.08% of cases. Pure tissue adhesion accounted for 38.46% of cases, while shredded Teflon pledget (STP) shifting was observed in 7.69% of cases. Postoperative outcomes were assessed through revisits and categorized into four groups: excellent (76.92%), good (15.38%), fair (7.69%), and poor (0%). The longest follow-up period exceeded 65 moths.The trans-lateral suboccipital infra-floccular approach provides a better visual field. Examination of entire length of the facial nerve is essential. STP with gelatin sponge implantation is a suitable material for facilitating nerve and vascular positioning and reducing adhesion.
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Affiliation(s)
- Zhu Wanchun
- Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Xinhua Hospital, No.1665 Kongjiang Road, Shanghai, 200092, China
| | - Liu Zhenxing
- Department of Neurosurgery, Liaocheng People's Hospital, No.45 Huashan Road, Liaocheng, Shangdong Province, China
| | - Zhao Hua
- Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Xinhua Hospital, No.1665 Kongjiang Road, Shanghai, 200092, China.
| | - Li Shiting
- Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Xinhua Hospital, No.1665 Kongjiang Road, Shanghai, 200092, China.
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Anudeep DDS, Karthik K, Holla VV, Kamble N, Yadav R, Pal PK, Mahale RR. Neurovascular conflict in primary hemifacial spasm: A radiological topographic and severity assessment of contact. Parkinsonism Relat Disord 2024; 128:107130. [PMID: 39243701 DOI: 10.1016/j.parkreldis.2024.107130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 09/01/2024] [Indexed: 09/09/2024]
Affiliation(s)
- D D S Anudeep
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India
| | - K Karthik
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India
| | - Vikram V Holla
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India
| | - Rohan R Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, India.
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Maytharakcheep S, Bhidayasiri R. Botulinum toxin treatment for hemifacial spasm: harmonising neurological and aesthetic outcomes. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02821-y. [PMID: 39174752 DOI: 10.1007/s00702-024-02821-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024]
Abstract
Hemifacial spasm (HFS) represents a challenging cranial movement disorder primarily affecting the facial nerve innervated muscles, with significant prevalence among Asians. Botulinum toxin type A (BoNT/A) injections, established as a primary therapeutic intervention since FDA approval, offer considerable effectiveness in alleviating spasms, albeit accompanied by challenges such as temporary effects and potential adverse events including facial asymmetry. This comprehensive review underscores the crucial need for harmonising neurological benefits and aesthetic outcomes in HFS management. The discussion delves into the interplay between facial aesthetics and neurological objectives in BoNT/A injections, emphasising precise techniques, dosages, and site considerations. Distinct aspects in neurological and aesthetic domains are also examined, including detailing the targeted muscles and injection methodologies for optimal therapeutic and aesthetic results. Importantly, evidence regarding various BoNT/A formulations, recommendations, and reconstitution guidelines in both neurology and aesthetics contexts are provided, along with a schematic approach outlining the stepwise process for BoNT/A injection in HFS treatment, addressing critical areas such as orbicularis oculi muscle sites, eyebrow correction strategies, mid- and lower-face considerations, contralateral injection sites, and post-injection follow-up and complication management. By highlighting the culmination of neurological efficacy and facial esthetics in BoNT/A treatment for HFS patients, this review proposes a holistic paradigm to achieve balanced symptomatic relief and natural aesthetic expression, ultimately enhancing quality of life for individuals grappling with HFS.
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Affiliation(s)
- Suppata Maytharakcheep
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.
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Fu W, Liang Q, Si M, Wang K, Li W, Ma X, Guo X. Application of the semidiving technique in fully endoscopic microvascular decompression. Neurosurg Rev 2024; 47:462. [PMID: 39174761 DOI: 10.1007/s10143-024-02715-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/13/2024] [Accepted: 08/18/2024] [Indexed: 08/24/2024]
Abstract
Microvascular decompression (MVD) is the preferred treatment for hemifacial spasm (HFS) and trigeminal neuralgia (TN), and fully endoscopic microvascular decompression (E-MVD) has been widely discussed in recent years. Considering the endoscopic diving technique used in endoscopic transsphenoidal pituitary adenoma resection, we developed the endoscopic semidiving technique. This technique involves preserving some cerebrospinal fluid (CSF) and positioning the endoscope at an appropriate distance from it; the potential advantages include reducing cerebellar retraction, accurately identifying the responsible vessels and minimizing mechanical damage. This study aimed to preliminarily evaluate the safety and feasibility of the semidiving technique in E-MVD. A total of 359 patients with HFS and TN scheduled to undergo E-MVD were included in the study. Patients with each disease were divided into a nonsemidiving technique group and a semidiving technique group. Surgical data, postoperative outcomes, complications, and recurrence rates were compared between the groups. In patients with HFS, the effective rate was 95.6% (nonsemidiving)and 92.9% (semidiving) respectively, with no statistically significant difference. The semidiving technique group had a lower incidence of postoperative permanent hearing loss compared with the nonsemidiving technique group (0% vs. 5.9%). In TN patients, no significant differences in effectiveness or postoperative complications were observed. The application of the semidiving technique in E-MVD for HFS not only ensures surgical quality and postoperative efficacy but also reduces the incidence of postoperative hearing loss, shortens the surgical duration and reduces the number of postoperative hospitalization days, aligning with the concept of enhanced recovery after surgery (ERAS).
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Affiliation(s)
- Weitao Fu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Qinghshun Liang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Mingbin Si
- Department of Neurosurgery, Jinan Third People's Hospital, Jinan, Shandong, China
| | - Kaili Wang
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Weiguo Li
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China
| | - Xiangyu Ma
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China.
| | - Xing Guo
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, China.
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El-Wahsh S, Fraser C, Vucic S, Reddel S. Neuromuscular junction disorders: mimics and chameleons. Pract Neurol 2024:pn-2024-004148. [PMID: 39174301 DOI: 10.1136/pn-2024-004148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 08/24/2024]
Abstract
Neuromuscular junction (NMJ) disorders represent a heterogenous group of acquired and congenital disorders that present in variable and distinctive ways. The diagnosis is typically reached through a combination of clinical, serological, pharmacological and electrophysiological evaluation. While the diagnosis can be fairly straightforward in some cases, the overlap with other neurological disorders can make diagnosis challenging, particularly in pure ocular presentations and in seronegative patients. The over-reliance on serological tests and electrophysiological evaluation in isolation can lead to misdiagnosis. In this article, we provide an overview of the NMJ disorders, discuss red flags for the key differential diagnoses (mimics) and report the atypical ways in which NMJ disorders may present (chameleons).
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Affiliation(s)
- Shadi El-Wahsh
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Neurology Department, Concord Hospital, Concord, New South Wales, Australia
| | - Clare Fraser
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Steve Vucic
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Neurology Department, Concord Hospital, Concord, New South Wales, Australia
| | - Stephen Reddel
- Neurology Department, Concord Hospital, Concord, New South Wales, Australia
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Li Z, Xiong F, Gao F, Yu B, Tu Y. Cortical changes in the brain of patients with hemifacial spasm. Neurol Sci 2024; 45:3209-3215. [PMID: 38286918 DOI: 10.1007/s10072-024-07353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE Hemifacial spasm (HFS) is a movement disorder characterized by involuntary muscle contractions on one side of the face. It is associated with disturbances in the brain's functional architecture. Despite this, the structural alterations in the brain related to HFS remain poorly understood. In this study, we investigated the cortical morphology changes in patients with HFS compared to healthy controls (HCs). METHODS We analyzed 3D T1-weighted MRI images from 33 patients with left-sided primary HFS and 33 age- and sex-matched HCs. Measurements of cortical thickness (CTh), sulcal depth, local gyrification index (lGI), and fractal dimension were taken using a computational anatomy toolbox. A general linear model, accounting for age, gender, and total brain volume, was applied for statistical analyses. Significant clusters were then assessed for correlations with clinical parameters. RESULTS The HFS patients displayed several cortical abnormalities when compared to HCs, including reduced CTh in the contralateral precentral gyrus and left orbitofrontal cortex, decreased sulcal depth in the left orbitofrontal cortex, and increased lGI in the right insula and superior temporal cortex. However, fractal dimension did not differ significantly between the groups. Additionally, in HFS patients, a notable negative correlation was found between the sulcal depth in the left orbitofrontal cortex and the Beck Depression Inventory-II scores. CONCLUSIONS Our findings reveal that HFS is associated with specific surface-based morphological changes in the brain. These alterations contribute to a deeper understanding of the neurophysiological mechanisms involved in HFS and may have implications for future research and treatment strategies.
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Affiliation(s)
- Zheng Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Xiong
- Department of Radiology, PLA Central Theater General Hospital, Wuhan, China
| | - Feng Gao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Buwei Yu
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ye Tu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Owashi E, Ohmura K, Shoda K, Yamada T, Kano K, Nakayama N, Iwama T. Comparison of transposition and interposition methods in microvascular decompression for hemifacial spasm: an analysis of 109 cases performed by a single surgeon in a single-center retrospective study. Acta Neurochir (Wien) 2024; 166:213. [PMID: 38740614 DOI: 10.1007/s00701-024-06111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Microvascular decompression (MVD), the standard surgical approach for hemifacial spasm (HFS), can be divided into the interposition and transposition methods. Although the risk of HFS recurrence following interposition has been reported, there is limited data comparing long-term outcomes between both methods performed by a single surgeon. This study aimed to investigate the efficacy of MVD techniques on HFS by comparing surgical outcomes performed by a single surgeon in a single-center setting. METHODS A total of 109 patients who underwent MVD were analyzed and divided into the transposition (86 patients) and interposition (23 patients) groups. Postoperative outcomes at 1 month and 1 year were assessed and compared, including rates of spasm relief, complications, and recurrence. RESULTS Outcome assessment revealed higher rates of early spasm relief in the interposition group (66.3% vs. 100%, transposition vs. interposition, respectively, p = 0.0004), although spasm relief at 1-year postoperatively was comparable between the two groups (84.9% vs. 95.7%, transposition vs. interposition, respectively, p = 0.2929). No significant differences were observed in complication and recurrence rates. Kaplan-Meier analysis demonstrated no significant differences in the duration of spasm resolution by MVD method (p = 0.4347, log-rank test). CONCLUSION This study shows that both the transposition (Surgicel® and fibrin glue) and interposition (sponge) methods were excellent surgical techniques. The interposition method may achieve earlier spasm resolution compared to the transposition method.
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Affiliation(s)
- Etsuko Owashi
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazufumi Ohmura
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kenji Shoda
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kiyomitsu Kano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
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Truong VT, Ngo MQ, Phan D, Le H, Tran Hoang NA. Results from 228 Patients with Hemifacial Spasm Undergoing Microvascular Decompression without Intraoperative Neuroelectrophysiology Monitoring. World Neurosurg 2024; 185:e461-e466. [PMID: 38369107 DOI: 10.1016/j.wneu.2024.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Intraoperative neuroelectrophysiology monitoring (IONM) has been used to decrease complications and to increase the successful rate of microvascular decompression (MVD) MVD for hemifacial spasm (HFS). Still, it is not available at limited resource centers. We report the outcome of patients undergoing MVD for HFS without using IONM. METHODS The variables concerning the patients' demographics (age and gender), clinical characteristics, offending vessels (vertebral artery type and non-vertebral artery type), postoperative grade of HFS, and postoperative complications of HFS patients undergoing MVD were retrospectively reviewed and collected. The scoring system provided by the Japan Society for MVD was used to evaluate the postoperative outcome of HFS. Postoperative hearing ability was evaluated according to a subjective assessment of the patients. RESULTS A total of 228 patients were recruited. Their median age was 51.0 (44.0-57.0) years old. The total cure effect was observed in 207 (90.8%) patients within the first week after the surgery and in 200 (96.1%) patients in a 2-year follow-up. Permanent hearing disturbance happened in 2 patients (0.9%). No patient had permanent unilateral deafness (0%). No postoperative permanent facial paralysis was reported. CONCLUSIONS MVD without IONM may be performed safely and effectively to treat patients with HFS.
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Affiliation(s)
- Van Tri Truong
- Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare system, Ho Chi Minh City, Vietnam.
| | - Minh Quan Ngo
- Department of Neurosurgery, Nhan Dan Gia Dinh hospital, Ho Chi Minh City, Vietnam
| | - Duy Phan
- Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare system, Ho Chi Minh City, Vietnam
| | - Hung Le
- Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare system, Ho Chi Minh City, Vietnam
| | - Ngoc Anh Tran Hoang
- Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare system, Ho Chi Minh City, Vietnam
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Jiang C, Wang J, Chong Y, Xu W, Liang W. Microvascular decompression for hemifacial spasm after Bell's palsy: a retrospective clinical study. Neurosurg Rev 2024; 47:92. [PMID: 38396231 DOI: 10.1007/s10143-024-02328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE This study aimed to investigate the clinical characteristics of hemifacial spasm (HFS) after Bell's palsy and to evaluate the therapeutic efficacy of microvascular decompression (MVD). METHODS A retrospective analysis was conducted on 18 patients who underwent MVD for HFS after Bell's palsy at our institution between January 1, 2017, and December 31, 2021. Clinical presentations, intraoperative findings, postoperative outcomes, and complications were comprehensively assessed. RESULTS Neurovascular compression (NVC) was identified in all the 18 patients. The offending vessels included anterior inferior cerebellar artery (AICA) in 6 patients (33.3%), posterior inferior cerebellar artery (PICA) in 7 patients (38.9%), vertebral artery (VA) combined with AICA in 3 patients (16.7%), and VA alongside PICA in 2 patients (11.1%). Notably, marked arachnoid membrane adhesion was evident in 11 patients (61.1%). 15(83.3%) patients were cured immediately after MVD, delayed relief was found in 3 (16.7%) patients. During the follow-up period, recurrence was not documented. Surgical complications were limited to facial paralysis in 3 patients and auditory impairment in 1 patient. No additional surgical complications were recorded. CONCLUSIONS In patients manifesting HFS after Bell's palsy, NVC predominantly underlies the etiology. MVD is a reliably safe and efficacious therapeutic intervention.
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Affiliation(s)
- Chengrong Jiang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210009, China
| | - Jing Wang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210009, China
| | - Yulong Chong
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210009, China
| | - Wu Xu
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210009, China.
| | - Weibang Liang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, 210009, China.
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Aktan D, Depierreux F. How to face the hemifacial spasm: challenges and misconceptions. Acta Neurol Belg 2024; 124:17-23. [PMID: 37498482 DOI: 10.1007/s13760-023-02342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023]
Abstract
Hemifacial spasm (HFS) is characterised by intermittent, brief or sustained, repetitive contractions of the muscles innervated by one facial nerve. It is one of the most frequent movement disorders affecting the face. However common and allegedly straightforward to diagnose, it might reveal as a challenge for clinicians in various situations. Indeed, it often needs prior exclusion of many other movement disorders affecting the face, with frequent phenomenological overlaps with blepharospasm, post-facial palsy, facial motor tics, etc. The clinical diagnosis shall be supported by modern brain imaging techniques, and sometimes electromyography, as some particular aetiologies may require specific treatment. Primary forms are associated with vascular compression of the ipsilateral seventh cranial nerve, whereas secondary forms can be caused by any injury occurring on the facial nerve course. This article proposes a global and organised approach to the diagnosis, and the ensuing therapeutic options, as many practitioners still use some inefficient medications when they encounter a case of facial spasm.
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Affiliation(s)
- David Aktan
- Neurology Department, University Hospital of Liège, CHU Liege, Avenue Hippocrate-B35, 4000, Liège, Belgium.
| | - Frédérique Depierreux
- Neurology Department, University Hospital of Liège, CHU Liege, Avenue Hippocrate-B35, 4000, Liège, Belgium
- Movement Disorder Unit, Neurology Department, CHU Liège, Liège, Belgium
- GIGA-CRC in vivo imaging, University of Liège, Liège, Belgium
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12
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Tian S, Zheng H, Wu L, Wu W. Factors influencing short-term prognosis after botulinum toxin type A treatment for hemifacial spasm:A retrospective study. Heliyon 2024; 10:e24898. [PMID: 38312606 PMCID: PMC10835370 DOI: 10.1016/j.heliyon.2024.e24898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/17/2023] [Accepted: 01/16/2024] [Indexed: 02/06/2024] Open
Abstract
Background It is widely acknowledged that botulinum toxin type A (BTX-A) has been widely used in the treatment of hemifacial spasm (HFS). However, there is currently a lack of systematic analysis of the factors affecting its therapeutic effect. Therefore, this study aims to explore the influencing factors of BTX-A in the treatment of HFS and to identify risk factors for poor prognosis. Methods Retrospective study including 118 patients with HFS treated with BTX-A from 2019 January to 2023 April. Demographic and etiological variables as well as doses, number of sessions of BTX-A, infiltrated muscles, therapeutic response according to the Cohen evaluation scale, and side effects were analyzed. Logistic regression analysis was performed to identify the factors that are associated with the short-term prognosis of BTX-A for the treatment of HFS. Results Among the 118 patients with HFS included in this study, 57 achieved complete relief, 51 had significant relief, 7 had partial relief, and no improvement was observed in 3. The overall effective rate was 91.53 %. Results from the univariate analysis indicated that male, drinking, diabetes, and hypertension were all associated with poor short-term prognosis of BTX-A in the treatment of HFS. Multivariable logistic regression analysis further revealed that hypertension was an independent risk factor for poor short-term prognosis following BTX-A treatment for HFS (OR=5.847, P<0.05). Conclusion BTX-A was effective in treating HFS and had minimal adverse effects. Hypertension was an independent risk factor for poor short-term prognosis following BTX-A treatment of HFS.
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Affiliation(s)
- Sheng Tian
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, China
| | - Heqing Zheng
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, China
| | - Lanxiang Wu
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, China
| | - Wei Wu
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, China
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Liang H, Liu J, Wang M, Luo G, Zhang Y. Mapping trends in hemifacial spasm research: bibliometric and visualization-based analyses of the Web of Science Core Collection. Neurosurg Rev 2024; 47:55. [PMID: 38243012 DOI: 10.1007/s10143-024-02294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/21/2024]
Abstract
Hemifacial spasm (HFS) is a common cranial nerve disease. In HFS research, we conducted a bibliometric analysis to examine the development and research trends. A retrieval of HFS studies published between 2011 and 2022 was performed from the Web of Science Core Collection in September 2022. Two scientometric tools were used to perform bibliometric and visualization-based analyses: VOSviewer and CiteSpace. Bibliometric analysis of 1461 studies published between 2011 and 2022 was carried out using data from 444 journals, 6021 authors, 1732 institutions, and 76 countries/regions. China, the USA, Japan, and South Korea were four key contributors to this study. Shanghai Jiaotong University was the major institution with the larger number of publications. Li Shiting was the most prolific author. Jannetta PJ was the most co-cited author. World Neurosurgery was the top prolific journal. Journal of Neurosurgery was the top co-cited journal. The top five keywords were hemifacial spasm, microvascular decompression, trigeminal neuralgia, surgery, and neurovascular compression. This study examines the research trends in global scientific research on HFS over the last decade. Researchers interested in learning more about current trends and novel research frontiers in this area can benefit from the study.
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Affiliation(s)
- Hao Liang
- Department of Neurosurgery, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, 510317, Guangdong, China
| | - Jiawen Liu
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, Guangzhou, 510317, Guangdong, China
| | - Mo Wang
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, Guangzhou, 510317, Guangdong, China
| | - Guoxuan Luo
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, Guangzhou, 510317, Guangdong, China.
| | - Yong Zhang
- Department of Neurosurgery, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, 510317, Guangdong, China.
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, Guangzhou, 510317, Guangdong, China.
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Nunta-Aree S, Kateyoi T, Sitthinamsuwan B. Delayed complete remission of hemifacial spasms following microvascular decompression and the implications for optimal time of revision surgery. Acta Neurochir (Wien) 2024; 166:12. [PMID: 38227077 DOI: 10.1007/s00701-024-05891-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Microvascular decompression (MVD) is an effective method for directly treating hemifacial spasms (HFS). The timing for the consideration of failed MVD and reoperation has been paradoxical. OBJECTIVE This study aimed to investigate the delayed complete remission of HFS in terms of prevalence rate, duration between surgery and delayed complete remission, and predictive factors. METHODS A hundred patients with HFS who underwent MVD from 2012-2021 were enrolled in the study. All HFS occurred as a result of compression of the facial nerve by adjacent blood vessels. Clinical information, intraoperative findings, and surgical outcomes were incorporated for data analysis. RESULTS In the first week after MVD, 67 of 100 patients achieved complete remission of HFS, while the remaining 33 had incomplete remission. In long-term follow-up, 26 individuals gradually developed delayed complete remission with a median duration of 9.1 months. Finally, 86 of 100 patients achieved complete long-term remission. Recurrent HFS and incomplete remission were found in 7 and 7 patients, respectively. Factors associated with postoperative complete remission in the first week were a severe degree of facial nerve compression (p = 0.047, OR 2.75, 95% CI 1.01-7.40), with long-term complete remission was left-sided HFS (p = 0.012, OR 5.73, 95% CI 1.47-22.36), and with the appearance of delayed complete remission was the prolonged duration of HFS at least 3 years before MVD (p = 0.046, OR 3.75, 95% CI 1.03-13.76). Transient facial paresis was found in 11% of the patients. Of them, facial nerve function recovered completely in all cases. CONCLUSIONS A delayed complete remission of HFS could be expected in long-term follow-up after MVD and is probably related to a longer duration of HFS before surgery. Unnecessary reoperation should be avoided in the early years following the first surgery.
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Affiliation(s)
- Sarun Nunta-Aree
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Thanthip Kateyoi
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand
- Department of Surgery, Prajuabkirikhan Hospital, Prajuabkirikhan, Thailand
| | - Bunpot Sitthinamsuwan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand.
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Maytharakcheep S, Phokaewvarangkul O, Bhidayasiri R. Does needle size matter? Effects of micro-hypodermic needle injections of botulinum toxin type A in patients with hemifacial spasm. Parkinsonism Relat Disord 2024; 118:105950. [PMID: 38081119 DOI: 10.1016/j.parkreldis.2023.105950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Botulinum toxin type A (BoNT/A) injections are the first-line treatment for primary hemifacial spasms (HFS), but require frequent painful injections. Although micro-hypodermic needles are commonly used for aesthetic BoNT/A injections to lessen pain and bruising, their benefits in HFS remain unclear. OBJECTIVE To compare side effects of BoNT/A injection, specifically pain and bruising, between primary HFS patients who received injections using micro-hypodermic needles (34-G) and those using standard needles (30-G). METHODS This cross-over, double-blind, randomised controlled trial involved HFS patients who received BoNT/A injections using either a 34-G or 30-G needle at two visits 12 weeks apart. Primary outcomes, pain and bruising were assessed immediately after injection using the Visual Analogue Scale (VAS) and Short-form McGill Pain Questionnaire (Thai version, SF-MPQ). Bruise assessment was also conducted one week after each injection. Secondary outcomes involved comparing efficacy of BoNT/A between the two types of needles and assessing other complications beyond pain and bruising. RESULTS 65 HFS patients (47 women and 18 men; mean age 59.46 ± 11.48 years; mean disease duration 5.86 ± 4.16 years) were included in the study. Patients who received 34-G needle injections reported significantly reduced pain, as indicated by VAS, total SF-MPQ scores, and bruise scores, compared to those who received 30-G needle injections (p < 0.001, each). There were no differences in efficacy or occurrence of other complications associated with BoNT/A between the two needle types. CONCLUSION In HFS patients, BoNT/A injections using micro-hypodermic needles resulted in reduced pain and bruising, compared to standard needles, while maintaining similar BoNT/A benefits.
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Affiliation(s)
- Suppata Maytharakcheep
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.
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16
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Jeon C, Kim M, Lee HS, Kong DS, Park K. Outcomes after Microvascular Decompression for Hemifacial Spasm without Definite Radiological Neurovascular Compression at the Root Exit Zone. Life (Basel) 2023; 13:2064. [PMID: 37895445 PMCID: PMC10608077 DOI: 10.3390/life13102064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/24/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
The purpose of this study was to investigate the outcome of microvascular decompression (MVD) in patients with hemifacial spasm (HFS) who have no definite radiological neurovascular compression (NVC). Sixteen HFS patients without radiological NVC on preoperative MRI underwent MVD surgery. The symptoms were left-sided in fourteen (87.5%) and right-sided in two patients (12.5%). Intraoperatively, the most common vessel compressing the facial nerve was the AICA (8, 44.4%), followed by arterioles (5, 27.8%), veins (4, 22.2%), and the PICA (1, 5.6%). The most common compression site was the cisternal portion (13, 76.5%) of the facial nerve, followed by the REZ (4, 23.5%). One patient (6.3%) was found to have multiple NVC sites. Arachnoid type (7, 50%) was the most common compressive pattern, followed by perforator type (4, 28.6%), sandwich type (2, 14.3%), and loop type (1, 7.1%). A pure venous compression was seen in two patients, while a combined venous-arterial "sandwich" compression was detected in two patients. Symptom improvement was observed in all of the patients. Only one patient experienced recurrence after improvement. Based on our experience, MVD surgery can be effective for primary HFS patients with no definite radiological NVC. MVD can be considered if the patient shows typical HFS features, although NVC is not evident on MRI.
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Affiliation(s)
- Chiman Jeon
- Department of Neurosurgery, Korea University Ansan Hospital, Ansan 15355, Republic of Korea;
| | - Minsoo Kim
- Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Republic of Korea;
| | - Hyun-Seok Lee
- Department of Neurosurgery, Konkuk University Medical Center, Seoul 05030, Republic of Korea;
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Kwan Park
- Department of Neurosurgery, Konkuk University Medical Center, Seoul 05030, Republic of Korea;
- Department of Neurosurgery, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
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Lee HS, Park K. Penetrating Offenders in Hemifacial Spasm: Surgical Tactics and Prognosis. Life (Basel) 2023; 13:2021. [PMID: 37895403 PMCID: PMC10608199 DOI: 10.3390/life13102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: In cases of hemifacial spasm (HFS), there are various patterns related to the vascular compression of the facial nerve, including a very rare form that is seen when the offending vessel penetrates the facial nerve. However, there have been few reports in the literature regarding the associated surgical techniques and postoperative prognosis. (2) Methods: A retrospective review was conducted of 4755 patients who underwent microvascular decompression (MVD) surgery from April 1997 to June 2023. In total, 8 out of the 4755 patients (0.2%) exhibited a penetrating offending vessel; the medical and surgical records of these 8 patients were then analyzed. Surgery was then attempted to maximally decompress the penetrating offender. (3) Results: Seven out of the eight patients (87.5%) were spasm-free immediately after surgery, and one had only 10% residual spasm compared to their preoperative condition. That patient was also spasm-free one year later. Postoperative facial palsy occurred in one patient (12.5%) who was assessed as grade II in the House-Brackmann grading system. In another patient, the resection of a small facial nerve bundle did not result in facial palsy. There were no cases of hearing loss or other complications. (4) Conclusions: Decompressing the penetrating offender did not increase the incidence of facial palsy, and the prognosis for hemifacial spasms was good. Therefore, when a penetrating pattern was encountered during MVD surgery, decompression between the penetrating offender and the facial nerve may offer good results.
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Affiliation(s)
- Hyun-Seok Lee
- Department of Neurosurgery, Konkuk University Medical Center, Seoul 05030, Republic of Korea;
| | - Kwan Park
- Department of Neurosurgery, Konkuk University Medical Center, Seoul 05030, Republic of Korea;
- Department of Neurosurgery, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
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Kalher M, Kaushik M, Vasudevan H, Narendran S, Mani KK, Ramakrishnan K, Rangarajan V, Shah VM. Clinical Profile of Patients with Hemifacial Spasm at a Tertiary Eye Care Center in South India: A Retrospective Study. J Curr Ophthalmol 2023; 35:395-400. [PMID: 39281403 PMCID: PMC11392308 DOI: 10.4103/joco.joco_295_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 09/18/2024] Open
Abstract
Purpose To assess the incidence and clinical profile of hemifacial spasm (HFS) and the association between HFS and systemic diseases. Methods This retrospective study was carried out on 85 patients with HFS, presenting at a tertiary eye care center in South India. Demographic and clinical details were recorded for all patients. Of these, the patients who had undergone magnetic resonance imaging (MRI) of the brain were analyzed for primary and secondary HFS. Results The mean age of the patients was 56.11 ± 12.51 years. The age at onset of HFS was 54.9 ± 12.7 years. The disease duration was 9.51 ± 7.28 years. Male:female ratio was 1:1.17. The right side was involved in 31 patients (36.47%) and the left side in 54 patients (63.52%). MRI was performed in 54 (63.52%) patients and showed neurovascular conflict in 22 (40.74%) patients and space-occupying lesions in 2 (3.70%) patients. Forty-nine (57.64%) patients had primary HFS, while five (5.88%) patients had secondary HFS due to old facial palsy in 3 and space-occupying lesions in two patients. Twenty (23.52%) patients received botulinum toxin A with a good response. Type of HFS had a significant association with hypertension (P = 0.046) while no significant association was present between laterality of HFS and systemic diseases (P > 0.05 each). Multivariate analysis showed a marginally significant association between type of HFS and hypertension (P = 0.057). Conclusions Primary HFS was the main type of HFS with female dominance and predilection for the left side. Hypertension had a relationship with HFS that needs to be investigated further for its causal nature.
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Affiliation(s)
- Manisha Kalher
- Department of General Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Madhurima Kaushik
- Department of General Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Haritha Vasudevan
- Department of General Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | | | - Karthik Kumar Mani
- Department of General Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Kavitha Ramakrishnan
- Department of General Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Viji Rangarajan
- Orbit and Oculoplasty Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Virna Mahesh Shah
- Neuro-Ophthalmology Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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Ghaffari-Rafi A, Choi SY, Leon-Rojas J, Shahlaie K. Predictors of Multi-Vessel Identification, Outcome, and Optimal Surgical Timing for Microvascular Decompression in Hemifacial Spasm. Clin Neurol Neurosurg 2023; 233:107841. [PMID: 37544024 DOI: 10.1016/j.clineuro.2023.107841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES AND BACKGROUND Hemifacial spasm (HFS) is a disabling condition that imposes significant burden upon patients. Microvascular decompression (MVD) surgery is the most effective and long-lasting treatment for HFS, but outcomes following this surgery may vary based on a variety of clinical and operative factors. A more thorough understanding of the variables that impact patient outcome after MVD surgery is needed. METHODS A systematic review and meta-analysis of Medline, Embase, and Central was conducted (n = 2108 screened; n = 86 included) with the goal of determining the impact of the following variables on outcome: duration of disease, geographic location, intraoperative use of an endoscope, and intraoperative finding of single versus multi-vessel neurovascular compression. RESULTS Most cases of hemifacial spasm occur on the left side (53.9%, p < 0.001) and are more common in women than men (66.5% versus 33.5%, p < 0.0001). The offending vessel frequencies were: 40.8% anterior inferior cerebellar artery [AICA], 24.9% posterior inferior cerebellar artery [PICA], 17.2% multiple vessels, and 4.7% vertebral artery [VA]. Multiple vessel combinations involved: 26.5% PICA + AICA, 24.6% PICA + VA, 23.1% AICA + VA, and 4.7% AICA + PICA + VA. Relative to the Americas, AICA was less frequent in Europe (p = 0.005), while PICA more frequent in Europe (p = 0.009) and Asia (p < 0.0001). With endoscope assistance, frequency of multiple vessels identified was 31.7% (versus 14.7% with non-endoscopic, p = 0.005), and 27.4% for AICA (43.5% with non-endoscopic, p = 0.003). Spasm improvement was 94.1% near discharge and 96.0% at maximum follow-up. Complications occurred in 16.5% of cases, with spasm recurrence in 2.4%. Greatest frequency of spasm improvement (p < 0.0001) and lowest spasm recurrence rates (p = 0.0005) were reported in series from Asia. For every additional month of pre-operative spasm, the effect size of post-operative improvement decreased (p = 0.04). With every subsequent postoperative month, the effect size of spasm improvement increased (p = 0.0497). The frequency of spasm improvement was significantly higher in series published after 2005 (94.4% versus 97.4%, p = 0.005). CONCLUSION Clinical outcomes following MVD for HFS have improved since 2005. Consideration should be given to earlier operation (shorter disease duration) and use of an endoscope may increase detection of multiple offending vessels. Further studies are needed to understand regional differences in culprit vessel incidence and surgical outcomes in the Americas, Europe, and Asia.
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Affiliation(s)
- Arash Ghaffari-Rafi
- University of California, Davis, School of Medicine, Department of Neurological Surgery, Sacramento, CA, USA; University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, HI, USA.
| | - So Yung Choi
- University of Hawai'i at Mānoa, John A. Burns School of Medicine, Department of Quantitative Health Sciences, Biostatistics Core Facility, Honolulu, HI, USA
| | - Jose Leon-Rojas
- Universidad de las Americas, Escuela de Medicina, Quito, Ecuador; University College London, Queen Square Institute of Neurology, London, England, UK
| | - Kiarash Shahlaie
- University of California, Davis, School of Medicine, Department of Neurological Surgery, Sacramento, CA, USA.
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Wu Y, Lan Y, Mao J, Shen J, Kang T, Xie Z. The interaction between the nervous system and the stomatognathic system: from development to diseases. Int J Oral Sci 2023; 15:34. [PMID: 37580325 PMCID: PMC10425412 DOI: 10.1038/s41368-023-00241-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
The crosstalk between the nerve and stomatognathic systems plays a more important role in organismal health than previously appreciated with the presence of emerging concept of the "brain-oral axis". A deeper understanding of the intricate interaction between the nervous system and the stomatognathic system is warranted, considering their significant developmental homology and anatomical proximity, and the more complex innervation of the jawbone compared to other skeletons. In this review, we provide an in-depth look at studies concerning neurodevelopment, craniofacial development, and congenital anomalies that occur when the two systems develop abnormally. It summarizes the cross-regulation between nerves and jawbones and the effects of various states of the jawbone on intrabony nerve distribution. Diseases closely related to both the nervous system and the stomatognathic system are divided into craniofacial diseases caused by neurological illnesses, and neurological diseases caused by an aberrant stomatognathic system. The two-way relationships between common diseases, such as periodontitis and neurodegenerative disorders, and depression and oral diseases were also discussed. This review provides valuable insights into novel strategies for neuro-skeletal tissue engineering and early prevention and treatment of orofacial and neurological diseases.
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Affiliation(s)
- Yuzhu Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yanhua Lan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Jiajie Mao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Jiahui Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Ting Kang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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21
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Hu X, Guo K, Li J, Wang X, Liu H, Yu Q, Kuang G, Li G, Huang J, Li H, Lin Z, Xiong N. Postoperative ecchymoma of eyelid after botulinum toxin injection for hemifacial spasm: a case report. Front Neurol 2023; 14:1171303. [PMID: 37545723 PMCID: PMC10398381 DOI: 10.3389/fneur.2023.1171303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Hemifacial spasm (HFS) is a rare movement disorder characterized by involuntary muscle contractions on one side of the face. Compared to the high therapeutic effect, adverse effects of botulinum toxin treatment for HFS occurred rarely. However, managing HFS patients who are also taking antithrombotic drugs poses a challenge. Here, we present a case of postoperative ecchymoma of the eyelid following a botulinum toxin injection in a patient receiving daily vinpocetine and aspirin antiplatelet therapy. This case highlights the importance of considering the potential risks and formulating a treatment plan that maximizes benefit while minimizing complications in HFS patients undergoing botulinum toxin injections and taking antithrombotic medications. To the best of our knowledge, this is the first reported case of postoperative ecchymoma of the eyelid following a botulinum toxin injection. Further research and additional case reports are needed to better understand the management strategies for this patient population.
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Affiliation(s)
- Xinyu Hu
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Kexin Guo
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jingwen Li
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyi Wang
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Hanshu Liu
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Qinwei Yu
- Department of Cardiology, Wuhan Red Cross Hospital, Wuhan, China
| | - Guiying Kuang
- Department of Neurology, Wuhan Red Cross Hospital, Wuhan, China
| | - Gang Li
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jinsha Huang
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Hongge Li
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhicheng Lin
- Laboratory of Psychiatric Neurogenomics, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | - Nian Xiong
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
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22
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Deshpande RD, Kshirsagar P, Yadav SP, Dole K, Bharucha K, Shetty R. Clinical study of patients with benign essential blepharospasm and hemifacial spasm. Indian J Ophthalmol 2023; 71:2625-2626. [PMID: 37322717 PMCID: PMC10417994 DOI: 10.4103/ijo.ijo_3173_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Rahul Dinkar Deshpande
- Department of Oculoplasty and Ocular Oncology, HV Desai Eye Hospital, Mohammadwadi, Pune, Maharashtra, India
| | - Pranjali Kshirsagar
- Department of General Ophthalmology, HV Desai Eye Hospital, Mohammadwadi, Pune, Maharashtra, India
| | - Sonal P Yadav
- Department of Oculoplasty and Ocular Oncology, HV Desai Eye Hospital, Mohammadwadi, Pune, Maharashtra, India
| | - Kuldeep Dole
- Department of General Ophthalmology, HV Desai Eye Hospital, Mohammadwadi, Pune, Maharashtra, India
| | - Khurshed Bharucha
- Department of General Ophthalmology, HV Desai Eye Hospital, Mohammadwadi, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of General Ophthalmology, HV Desai Eye Hospital, Mohammadwadi, Pune, Maharashtra, India
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Early-Onset Insomnia among Patients with Hemifacial Spasm in South Korea: A Nationwide Cohort Study. J Pers Med 2023; 13:jpm13020197. [PMID: 36836430 PMCID: PMC9964016 DOI: 10.3390/jpm13020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
This study aimed to investigate mental illnesses among patients with hemifacial spasms (HFS) based on nationwide claims data from the South Korea Health Insurance Review and Assessment Service. In this retrospective study, we defined the HFS group as subjects aged between 20 and 79 years with newly diagnosed HFS between January 2011 and December 2019 and set the date of diagnosis of HFS as the index date. Mental illnesses were defined through the International Classification of Diseases, the tenth revision from 90 days before to after the index date. Of these patients, we enrolled the participants who had visited a psychiatric outpatient clinic more than twice or had been admitted to a psychiatric department more than once diagnosed with psychiatric diseases. To select the control group, which was four times larger than the HFS group, propensity scores were used among those not diagnosed with HFS. The patients with HFS were more likely to have a mental illness than the control group (8.5% and 6.5%, respectively, p < 0.001) within 90 days before and after diagnosis. Among mental illnesses, insomnia (46.2% vs. 13.0%, p < 0.001) was significantly more prevalent in the HFS group. Other mental illnesses were significantly more prevalent in the control group or were not statistically significant. The results of this study suggest that patients diagnosed with HFS were significantly more likely to develop insomnia within a relatively short period than the controls.
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Bayraktar Bilen N, Bilen S. Evaluating the topographical measurements and tear function status in patients with hemifacial spasm: A comparative fellow eye study. Eur J Ophthalmol 2023; 33:216-222. [PMID: 35787190 DOI: 10.1177/11206721221112518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate the effect of eyelid spasm on corneal and tear film characteristics in patients with hemifacial spasm (HFS) and compare these data with those of the contralateral eyes of the same patients. METHODS This prospective study is comprised of 64 eyes of 32 HFS patients, 32 eyes on the spasm side (Group 1) and 32 contralateral eyes (Group 2). Corneal tomographic analyses were performed; corneal power of flat axis (K1) and steep axis (K2), astigmatism and thinnest pachymetry; anterior, posterior and total corneal aberrometry [spherical aberration (SA), vertical coma (vcoma), horizontal coma (hcoma), total higher order aberration (THOA) and total RMS], and corneal densitometry values were evaluated and compared between groups. Tear meniscus height and depth (TMH, TMD) were measured using anterior segment optic coherence tomography. Tear function tests including TMH and TMD, the Schirmer I test, and tear break-up time (TBUT) were compared between the groups. RESULTS K1, K2, astigmatism and corneal densitometry values were similar between groups (p > 0.05). Thinnest pachymetry values were significantly thinner on the spasm side (p = 0.040). Anterior and total corneal SA and RMS were significantly higher on the spasm side (p = 0.032, p = 0.005; p = 0.015, p = 0.006, respectively). TMH, TMD and TBUT were significantly lower in Group 1 (p = 0.01, p = 0.02 and p = 0.03, respectively). Schirmer I test values were similar between groups (p > 0.05). CONCLUSION In HFS patients, there are changes in corneal parameters and tear film in the eye on the spasm side compared to unaffected eye.
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Affiliation(s)
| | - Sule Bilen
- Department of Neurology, Ankara Bilkent City Hospital, Ankara, Turkey
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Gong Y, Li X, Zhou X, Pan T, Wang H, Chen C, Wang J, Wang S, Chen X. Acupuncture treatment of facial spasm: An overview of systematic reviews. Medicine (Baltimore) 2022; 101:e32182. [PMID: 36550879 PMCID: PMC9771242 DOI: 10.1097/md.0000000000032182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To provide evidence, this review evaluated the methodological quality, risk of bias, and reporting quality of SRs/MAs in the treatment of Facial Spasm with acupuncture. METHODS Systematic reviews and Meta analyses (SRs/MAs) of acupuncture for Facial Spasm were retrieved from 8 databases from inception to October 1, 2022. Two reviewers independently screened the literature and extracted the data, then used Assessment of Multiple Systematic Reviews-2 (AMSTAR-2), Bias Risk in Systematic Review (ROBIS), and Preferred Report Item for Systematic review and Meta-analysis (PRISMA), Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to assess methodological quality, risk of bias, quality of reporting, and quality of evidence. RESULTS A total of 8 SRs/meta-analyses were included. All the SRs were published between 2012-2022. Based on AMSTAR-2, 8 SRs were rated critically low quality. By using the ROBIS tool, 6 SRs were rated low-risk bias. With the PRISMA-A checklist, we found 2 out of 8 SRs were found adequately reported over 70%. With the GRADE system, no high-quality evidence was found, and only two outcomes provided moderate-quality evidence. Among the downgraded factors, the risk of bias within the original trials was ranked first, followed by publication bias, inconsistency, and imprecision. CONCLUSION Acupuncture is a promising complementary treatment for HFS. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples are needed before widespread recommendations can be made.
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Affiliation(s)
- Yubo Gong
- Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Xuefeng Li
- Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Xue Zhou
- Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Ting Pan
- Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Haili Wang
- Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Chunhai Chen
- The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Jing Wang
- The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Siyi Wang
- Changchun University of Chinese Medicine, Changchun, People’s Republic of China
| | - Xinhua Chen
- The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China
- * Correspondence: Xinhua Chen, No. 1478, Hongqi Street, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin Province, China(e-mail: )
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Wenninger FC, Wabbels B. Frequency of Hemorrhagic Side Effects of Botulinum Neurotoxin Treatment in Patients with Blepharospasm and Hemifacial Spasm on Antithrombotic Medication. Toxins (Basel) 2022; 14:toxins14110769. [PMID: 36356019 PMCID: PMC9693354 DOI: 10.3390/toxins14110769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to investigate the frequency of hemorrhagic side effects of botulinum neurotoxin A injections (BoNT/A) for the treatment of benign essential blepharospasm (BEB) and hemifacial spasm (HFS) in patients taking antithrombotic drugs (ATD). A total of 140 patients were included (female: 65%; BEB: 75%; mean age: 70 ± 12 years). According to their current antithrombotic medication, participants were either assigned to the ATD group (41%), or to the control group (59%). The ATD group was further divided into subgroups depending on the medication administered: acetylsalicylic acid, ADP receptor antagonists, direct oral anticoagulants, vitamin-K antagonists, or dual antiplatelet therapy. The frequency of hemorrhagic side effects was recorded by retrospective analysis of past treatments as documented in the patient's file set in relation to the number of past treatments (hematoma frequency of past treatments, HFretro) as well as by a prospective survey capturing the side effects of one single treatment (hematoma frequency of actual treatment, HFactual). There was no significant difference in hematoma frequency between the ATD group and the control group, neither for past (HFretro: ATD: 2%; 45/2554; control: 4%; 109/2744) nor for the current BoNT/A treatments (HFactual: ATD: 30%; 16/53; control: 31%; 22/72). Even between ATD subgroups, hematoma frequency did not differ significantly. Overall, hemorrhagic side effects of the BoNT/A treatment for BEB and HFS were mild and non-disabling.
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Affiliation(s)
- Fiona Carolin Wenninger
- Department of Ophthalmology, University Hospital of Bonn, Ernst-Abbe-Str. 2, D-53127 Bonn, Germany
- Department of Neurology, University Hospital of Münster, Albert-Schweitzer-Campus 1, D-48149 Münster, Germany
| | - Bettina Wabbels
- Department of Ophthalmology, University Hospital of Bonn, Ernst-Abbe-Str. 2, D-53127 Bonn, Germany
- Correspondence: ; Tel.: +49-(0)228-287-15612; Fax: +49-(0)228-287-14692
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Hemifacial Spasm Caused by Distal Neurovascular Compression Confirmed by Lateral Spread Response Monitoring. J Craniofac Surg 2022; 33:2555-2559. [DOI: 10.1097/scs.0000000000008820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 02/04/2023] Open
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Mishra A, Pandey S. Functional Neurological Disorders: Clinical Spectrum, Diagnosis, and Treatment. Neurologist 2022; 27:276-289. [PMID: 35858632 DOI: 10.1097/nrl.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Functional neurological disorders (FNDs) are common but often misdiagnosed. REVIEW SUMMARY The incidence of FNDs is between 4 and 12 per 100,000, comparable to multiple sclerosis and amyotrophic lateral sclerosis, and it is the second most common diagnosis in neurology clinics. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, and history of other somatic symptoms. Anxiety and depression are common, but not necessarily more than in the general population. Although there are no tests currently capable of demonstrating whether symptoms are willfully produced, there may not be a clear categorical difference between voluntary and involuntary symptoms. The prognosis of an FND is linked to early diagnosis and symptom duration, but unfortunately, the majority of the patients are diagnosed after considerable delays. CONCLUSIONS A positive diagnosis of FNDs can be made on the basis of history and neurological signs without reliance on psychological stressors. Past sensitizing events and neurobiological abnormalities contribute to the pathogenesis of FNDs. Physical rehabilitation and psychological interventions alone or in combination are helpful in the treatment.
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Affiliation(s)
- Anumeha Mishra
- Department of Neurology, Govind Ballabh Pant Postgraduate institute of medical education and research; New Delhi, India
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29
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Safety and efficacy of clonazepam in patients with hemifacial spasm: A double-blind, randomized, placebo-controlled trial. Parkinsonism Relat Disord 2022; 103:1-6. [DOI: 10.1016/j.parkreldis.2022.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/21/2022] [Accepted: 07/30/2022] [Indexed: 11/18/2022]
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30
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Jiang H, Wang P, Zhou D, Zeng L, Lin B, Wu N. Fully endoscopic microvascular decompression for hemifacial spasm. Exp Ther Med 2022; 24:483. [PMID: 35761812 PMCID: PMC9214605 DOI: 10.3892/etm.2022.11410] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/10/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hao Jiang
- Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
| | - Pan Wang
- Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
| | - De Zhou
- Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
| | - Long Zeng
- Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
| | - Bo Lin
- Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
| | - Nan Wu
- Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
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Pham AH, Duong HD, Chu HT, Vu HT, Pham DT, Dong HV. Endoscopic assisted microvascular decompression for vertebral artery - Associated hemifacial spasm – A case report. Ann Med Surg (Lond) 2022; 75:103461. [PMID: 35386781 PMCID: PMC8977919 DOI: 10.1016/j.amsu.2022.103461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction and importance: Vertebral-artery associated hemifacial spasm is rare. Microvascular decompression (MVD) of hemifacial spasm (HFS) associated with the vertebral artery (VA) shows high rates of incomplete cure and complications compared to non-VA-related HFS. Case presentation A 39-year-old male who presented with a 2-year history of progressive left-sided typical HFS. Endoscopic assisted MVD for VA-associated HFS via a retro-sigmoid keyhole was performed. Neurovascular conflicts by both the VA and the AICA around the root exit zone of the facial nerve in sandwich type were successfully decompressed. Clinical discussion Vertebral-artery associated hemifacial spasm is challenging. With the assistance of endoscopy, multiple neurovascular conflicts were clearly demonstrated without significant cerebellar retraction. The VA and AICA were safely interposed with preservation of perforators under excellent view. Conclusion Endoscopic assisted MVD offers reliable decompression with minimum invasiveness in case of VA-associated HFS with multiple compressions. Vertebral artery- associated hemifacial spasm is rare and challenging. Endoscope assisted MVD was an effective treatment of VA- associated HFS. Utilization of endoscope provides a broader view without brain retraction and ability to identify multiple compressions.
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32
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Gat L, Gerston A, Shikun L, Inzelberg L, Hanein Y. Similarities and disparities between visual analysis and high-resolution electromyography of facial expressions. PLoS One 2022; 17:e0262286. [PMID: 35192638 PMCID: PMC8863227 DOI: 10.1371/journal.pone.0262286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
Computer vision (CV) is widely used in the investigation of facial expressions. Applications range from psychological evaluation to neurology, to name just two examples. CV for identifying facial expressions may suffer from several shortcomings: CV provides indirect information about muscle activation, it is insensitive to activations that do not involve visible deformations, such as jaw clenching. Moreover, it relies on high-resolution and unobstructed visuals. High density surface electromyography (sEMG) recordings with soft electrode array is an alternative approach which provides direct information about muscle activation, even from freely behaving humans. In this investigation, we compare CV and sEMG analysis of facial muscle activation. We used independent component analysis (ICA) and multiple linear regression (MLR) to quantify the similarity and disparity between the two approaches for posed muscle activations. The comparison reveals similarity in event detection, but discrepancies and inconsistencies in source identification. Specifically, the correspondence between sEMG and action unit (AU)-based analyses, the most widely used basis of CV muscle activation prediction, appears to vary between participants and sessions. We also show a comparison between AU and sEMG data of spontaneous smiles, highlighting the differences between the two approaches. The data presented in this paper suggests that the use of AU-based analysis should consider its limited ability to reliably compare between different sessions and individuals and highlight the advantages of high-resolution sEMG for facial expression analysis.
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Affiliation(s)
- Liraz Gat
- School of Electrical Engineering, Tel Aviv University, Tel Aviv, Israel
- Tel Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv University, Tel Aviv, Israel
| | - Aaron Gerston
- Tel Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv University, Tel Aviv, Israel
- X-trodes, Herzelia, Israel
| | - Liu Shikun
- School of Electrical Engineering, Tel Aviv University, Tel Aviv, Israel
- Tel Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv University, Tel Aviv, Israel
| | - Lilah Inzelberg
- Tel Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yael Hanein
- School of Electrical Engineering, Tel Aviv University, Tel Aviv, Israel
- Tel Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- X-trodes, Herzelia, Israel
- * E-mail:
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33
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Jost WH, Laskawi R, Palmowski-Wolfe A, Spittau B, Urban PP. [Therapy of Hemifacial Spasm with Botulinum Toxin: an Update]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:37-41. [PMID: 35021244 DOI: 10.1055/a-1677-4008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Injections of botulinum toxin can be viewed by now as the therapy of choice in treating hemifacial spasm (HFS). Each of the three botulinum toxin-A preparations have been approved for this indication in Germany. HFS is a frequent disease characterized by involuntary contractions of the muscles of one half of the face innervated by the facial nerve. The symptoms can be either tonic or clonic, intermittant or permanent. Diagnosis is based purely on clinical observation. A magnetic resonance imagingof the skull is appropriate to demonstrate nerve-vessel contact as most frequent cause and to exclude other pathologies.
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Affiliation(s)
| | - Rainer Laskawi
- Hals-Nasen-Ohrenklinik, Universitätsmedizin Göttingen, Göttingen
| | | | - Björn Spittau
- Anatomie und Zellbiologie, Medizinische Fakultät OWL, Universität Bielefeld
| | - Peter P Urban
- Asklepios Klinik Barmbek, Abt. für Neurologie, Hamburg
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Fang TC, Chen CM, Chang MH, Wu CH, Guo YJ. Altered Functional Connectivity and Sensory Processing in Blepharospasm and Hemifacial Spasm: Coexistence and Difference. Front Neurol 2022; 12:759869. [PMID: 34975723 PMCID: PMC8715087 DOI: 10.3389/fneur.2021.759869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/23/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Blepharospasm (BSP) and hemifacial spasm (HFS) are both facial hyperkinesia however BSP is thought to be caused by maladaptation in multiple brain regions in contrast to the peripherally induced cause in HFS. Plausible coexisting pathophysiologies between these two distinct diseases have been proposed. Objectives: In this study, we compared brain resting state functional connectivity (rsFC) and quantitative thermal test (QTT) results between patients with BSP, HFS and heathy controls (HCs). Methods: This study enrolled 12 patients with BSP, 11 patients with HFS, and 15 HCs. All subjects received serial neuropsychiatric evaluations, questionnaires determining disease severity and functional impairment, QTT, and resting state functional MRI. Image data were acquired using seed-based analyses using the CONN toolbox. Results: A higher cold detection threshold was found in the BSP and HFS patients compared to the HCs. The BSP and HFS patients had higher rsFC between the anterior cerebellum network and left occipital regions compared to the HCs. In all subjects, impaired cold detection threshold in the QTT of lower extremities had a correlation with higher rsFC between the anterior cerebellar network and left lingual gyrus. Compared to the HCs, increased rsFC in right postcentral gyrus in the BSP patients and decreased rsFC in the right amygdala and frontal orbital cortex in the HFS subjects were revealed when the anterior cerebellar network was used as seed. Conclusions: Dysfunction of sensory processing detected by the QTT is found in the BSP and HSP patients. Altered functional connectivity between the anterior cerebellar network and left occipital region, especially the Brodmann area 19, may indicate the possibility of shared pathophysiology among BSP, HFS, and impaired cold detection threshold. Further large-scale longitudinal study is needed for testing this theory in the future.
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Affiliation(s)
- Ting-Chun Fang
- Department of Neurology, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Chun-Ming Chen
- Department of Medical Imaging, China Medical University Hospital, Taichung City, Taiwan
| | - Ming-Hong Chang
- Department of Neurology, Taichung Veterans General Hospital, Taichung City, Taiwan.,College of Life Science, National Chung Hsing University, Taichung City, Taiwan
| | - Chen-Hao Wu
- Department of Radiology, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Yi-Jen Guo
- Department of Neurology, Taichung Veterans General Hospital, Taichung City, Taiwan
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35
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Blue R, Howard S, Spadola M, Kvint S, Lee JYK. Endoscopic Microvascular Decompression for Hemifacial Spasm: A Technical Case Report Demonstrating the Benefits of the Angled Endoscope and Intraoperative Neuromonitoring. Cureus 2021; 13:e16586. [PMID: 34434679 PMCID: PMC8380448 DOI: 10.7759/cureus.16586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 11/08/2022] Open
Abstract
A 57-year-old female with eight years of hemifacial spasm (HFS) underwent endoscopic microvascular decompression (MVD) of the facial nerve. Baseline stimulation of the zygomatic branch of the facial nerve activated at 1.2 mA. Lateral spread response (LSR) to the buccal and mandibular branches was observed at 2.2 mA. A straight endoscope was used to enter the cerebellopontine angle, allowing for visualization of the vestibulocochlear and facial nerve. Neurovascular compression was not clearly identified. A 30-degree endoscope was directed medially/inferiorly and compression at the root entry zone was identified and decompressed. Subsequent LSR to the buccal/mandibular branches was seen at 3.2 mA/3.6 mA, respectively. Additional vascular compression was suspected given persistent LSR. The 30-degree endoscope was directed laterally. Compression was seen at the porus acustics and decompressed. Subsequent LSR to the buccal/mandibular branches was not observed until 9.8 mA, indicating good decompression. The patient tolerated the procedure well with complete resolution of her symptoms and remains spasm-free as of three months post-procedure without a hearing deficit. The 30-degree endoscope enabled visualization of pathology that was not easily seen at 0-degree. Additionally, LSR indicated persistent nerve compression following root entry zone decompression. Subsequent distal decompression resulted in greater LSR reduction. This case report suggests that MVD for HFS may yield better results with both proximal and distal decompression of the seventh nerve, and this type of decompression can benefit from endoscopic visualization.
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Affiliation(s)
- Rachel Blue
- Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Susanna Howard
- Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Michael Spadola
- Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Svetlana Kvint
- Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
| | - John Y K Lee
- Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, USA
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Badarny S, Ibrahim R, Susel Z, Zaina A, Nasar R, Badarny Y. Long-term stable efficacy of botulinum toxin A in facial movement disorders with no need for increasing dose. Medicine (Baltimore) 2021; 100:e26481. [PMID: 34160460 PMCID: PMC8238266 DOI: 10.1097/md.0000000000026481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/28/2021] [Indexed: 01/04/2023] Open
Abstract
Botulinum toxin A is considered an effective treatment for involuntary facial movements. We examined whether treatment efficacy maintained or changed over time with two products, Botox and Dysport, in patients with hemifacial spasm, facial synkinesis and benign essential blepharospasm.We retrospectively investigated 87 consecutive patients (51 women, 36 men) who had undergone treatment for ≥6 years. Long-term effects, as well as side effects of Botox or Dysport local injections were evaluated. The first three treatments were considered the titration period and not taken into account when testing for dose changes.Mean treatment duration was 10 years (range 6-11, SD 1.0), 2441 treatments were administered, 1162 with Botox and 1279 with Dysport, the two brands were interchanged as needed. Good to full improvement was seen in 90% of patients both with both brands. Injection doses and treatment responses were consistent during the study with both drugs. No major side effects were reported, and relatively few minor adverse events were reported, with clear reduction from the titration period (6.1%), to the remainder of the study (3.9%).Botulinum toxin (BTX-A) is a satisfactory long-term treatment without need for dose increase over. Both Botox and Dysport were effective when used interchangeably.
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Affiliation(s)
- Samih Badarny
- Department of Neurology, Galilee Medical Center Naharyia
- Bar Ilan Faculty of Medicine, Safed
| | - Raphiq Ibrahim
- Edmond J. Safra Brain Research Center & Department of Learning Disabilities, University of Haifa, Haifa
| | | | - Adnan Zaina
- Endocrinology Clinic, Zvulun Medical Clinic, Kiryat Bialik
| | | | - Yazid Badarny
- Department of Neurosurgery, Rambam Medical Center, Haifa, Israel
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Bhagwat AA, Deogaonkar M, Deopujari CE. Microsurgery and Neuromodulation for Facial Spasms. Neurol India 2021; 68:S196-S201. [PMID: 33318350 DOI: 10.4103/0028-3886.302455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Facial spasms are of various types. Hemifacial spasm (HFS) is characterized by unilateral tonic-clonic contractions of facial muscles, following a specific pattern of disease progression. It has well-delineated clinical, radiological and electrophysiological features. We have conducted an extensive review of existing literature on the subject, as regards etiopathogenesis, clinical features, investigations and management options for facial spasms. Primary Hemifacial spasm (HFS) may be treated using pharmacotherapy, botulinum toxin injections or microvascular decompression surgery. Microvascular decompression has the potential to reverse the pathological changes of the disease and has proved to be the most successful of all treatment options. Other facial spasms are exceedingly difficult to treat and may need neuromodulation as an option. The following article attempts to review the clinical features and therapeutic approaches to managing patients with facial spasms.
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Affiliation(s)
- Aniruddha A Bhagwat
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Milind Deogaonkar
- Department of Neurosurgery, University of West Virginia, Medical Centre Drive, Morgantown WV, USA
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Mizobuchi Y, Nagahiro S, Kondo A, Arita K, Date I, Fujii Y, Fujimaki T, Hanaya R, Hasegawa M, Hatayama T, Hongo K, Inoue T, Kasuya H, Kobayashi M, Kohmura E, Matsushima T, Masuoka J, Morita A, Munemoto S, Nishizawa S, Okayama Y, Sato K, Shigeno T, Shimano H, Takeshima H, Tanabe H, Yamakami I. Prospective, Multicenter Clinical Study of Microvascular Decompression for Hemifacial Spasm. Neurosurgery 2021; 88:846-854. [PMID: 33469667 DOI: 10.1093/neuros/nyaa549] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Microvascular decompression (MVD) is the most effective procedure for hemifacial spasm (HFS). MVD results from nonspecialized or low-volume institutes are not always reliable. Most studies on MVD for HFS are retrospective and single centered; to the best of our knowledge, no prospective, multicenter studies exist. OBJECTIVE To evaluate short- and long-term outcomes and complications in patients who underwent MVD for HFS in specialized Japanese institutions, in this multicenter, prospective, cohort study. METHODS Included patients had undergone MVD for HFS in study centers between April 2012 and March 2015. Patients' postoperative grade of involuntary movements and complications were recorded postoperatively at 7 d (short-term) and at 1 (mid-term) and 3 (long-term) yr. RESULTS A total of 486 patients (150 men, 336 women; mean age 53.9 yr with 181 patients over 60 yr) were enrolled during the study period. Neuromonitoring was used in 96.3% of the cases. The complete cure rate of symptom relief, mortality rate, and complication rate at short-term follow-up were 70.6%, 0%, and 15%, respectively. The long-term follow-up was completed by 463 patients (95.3%); the complete cure rate of symptom relief and complication rate were 87.1% and 3.0%, respectively. CONCLUSION Our study revealed that under expert guidance and intraoperative neuromonitoring, the long-term curative effect rate of MVD for HFS is high, while complications are uncommon and usually transient. Our results indicate that MVD is an effective and safe treatment for patients with HFS, including elderly patients.
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Affiliation(s)
- Yoshifumi Mizobuchi
- Department of Neurosurgery, Tokushima University Faculty of Medicine, Tokushima, Japan
| | - Shinji Nagahiro
- Department of Neurosurgery, Tokushima University Faculty of Medicine, Tokushima, Japan
| | - Akinori Kondo
- Brain and Spine Surgery Center, Shiroyama Hospital, Osaka, Japan
| | - Kazunori Arita
- Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Isao Date
- Okayama University Graduate School of Medicine, Okayama, Japan
| | | | | | - Ryosuke Hanaya
- Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | | | | | - Tooru Inoue
- Graduate School of Medical Sciences, Fukuoka University, Fukuoka, Japan
| | - Hidetoshi Kasuya
- Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | | | - Eiji Kohmura
- Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Jun Masuoka
- Faculty of Medicine, Saga University, Saga, Japan
| | | | | | - Shigeru Nishizawa
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshihiro Okayama
- Department of Neurosurgery, Tokushima University Faculty of Medicine, Tokushima, Japan
| | - Kimitoshi Sato
- Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Hiroshi Shimano
- Brain and Spine Surgery Center, Shiroyama Hospital, Osaka, Japan
| | - Hideo Takeshima
- Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Wabbels B, Yaqubi A. Validation of a new hemifacial spasm grading questionnaire (HFS score) assessing clinical and quality of life parameters. J Neural Transm (Vienna) 2021; 128:793-802. [PMID: 33963897 PMCID: PMC8205881 DOI: 10.1007/s00702-021-02343-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/20/2021] [Indexed: 11/08/2022]
Abstract
Validation of the new hemifacial spasm (HFS) questionnaire “HFS score” that captures both clinical (HFS clinical) and health-related quality of life (HRQOL) parameters (HFS subjective) in one tool and comparison with a global HRQOL questionnaire. Cross sectional, prospective validation study including 143 subjects (62 HFS patients and 81 healthy volunteers) from the University Eye Hospital Bonn. Patients were interviewed with the new HFS score and the SF-12 questionnaire prior to and 3 weeks after Botulinum neurotoxin A (BoNT-A) injection. All HRQOL-related questions (HFS subjective) were answered on a visual analogue scale (VAS) ranging from 0 (no complaints) to 100% (maximum complaints) by the patients themselves. Reproducibility was tested in a study extension with 10 patients by repeat interviews (telephone/personal). The new HFS score questionnaire provided a reliable clinical assessment and demonstrated that BoNT-A therapy significantly reduced frequency and severity of eye and cheek spasms (p < 0.001; Wilcoxon test). Relevant aspects of HRQOL of HFS patients were assessed with high accuracy and sensitivity. Significant improvements were achieved after BoNT-A injection in five out of eight HRQOL parameters (p ≤ 0.02; Wilcoxon test). Cronbach’s alpha of 0.818 demonstrated good internal consistency. Telephone survey provided comparable results to personal interviews. This new sensitive and specific HFS score seems a reliable instrument to monitor BoNT therapy and customize it to the needs of the individual HFS patient—in clinical studies and daily clinical practice.
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Affiliation(s)
- Bettina Wabbels
- Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.
| | - Ali Yaqubi
- Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.,Ophthalmological Center Lippstadt, Wiedenbrücker Str. 31, 59555, Lippstadt, Germany
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Traylor KS, Sekula RF, Eubanks K, Muthiah N, Chang YF, Hughes MA. Prevalence and severity of neurovascular compression in hemifacial spasm patients. Brain 2021; 144:1482-1487. [PMID: 33842948 PMCID: PMC8262979 DOI: 10.1093/brain/awab030] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/03/2020] [Accepted: 11/19/2020] [Indexed: 11/18/2022] Open
Abstract
Hemifacial spasm is typically caused by vascular compression of the proximal intracranial facial nerve. Although the prevalence of neurovascular compression has been investigated in a cohort of patients with classical trigeminal neuralgia, the prevalence and severity of neurovascular compression has not been well characterized in patients with hemifacial spasm. We aimed to investigate whether presence and severity of neurovascular compression are correlated to the symptomatic side in patients with hemifacial spasm. All patients in our study were evaluated by a physician who specializes in the management of cranial nerve disorders. Once hemifacial spasm was diagnosed on physical exam, the patient underwent a dedicated cranial nerve protocol magnetic resonance imaging study on a 3 T scanner. Exams were retrospectively reviewed by a neuroradiologist blinded to the symptomatic side. The presence, severity, vessel type, and location of neurovascular compression along the facial nerve was recorded. Neurovascular compression was graded as contact alone (vessel touching the facial nerve) versus deformity (indentation or deviation of the nerve by the culprit vessel). A total of 330 patients with hemifacial spasm were included. The majority (232) were female while the minority (98) were male. The average age was 55.7 years. Neurovascular compression (arterial) was identified on both the symptomatic (97.88%) and asymptomatic sides (38.79%) frequently. Neurovascular compression from an artery along the susceptible/proximal portion of the nerve was much more common on the symptomatic side (96.36%) than on the asymptomatic side (12.73%), odds ratio = 93.00, P < 0.0001. When we assessed severity of arterial compression, the more severe form of neurovascular compression, deformity, was noted on the symptomatic side (70.3%) much more frequently than on the asymptomatic side (1.82%) (odds ratio = 114.00 P < 0.0001). We conclude that neurovascular compression that results in deformity of the susceptible portion of the facial nerve is highly associated with the symptomatic side in hemifacial spasm.
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Affiliation(s)
- Katie S Traylor
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Raymond F Sekula
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Komal Eubanks
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Nallammai Muthiah
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Yue-Fang Chang
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Marion A Hughes
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Alciato L, Simon F, Hervochon R, Trunet S, Nouet A, Tankéré F. Quality of life after hemifacial spasm surgery: French versions of the HFS-8 and HFS-30 questionnaires. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138:425-430. [PMID: 33832863 DOI: 10.1016/j.anorl.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of the present study was to assess quality of life before and after surgery for hemifacial spasm, in order to validate two specific quality of life scales translated in French. Surgical results and complications were reported. MATERIAL AND METHODS Twenty-three patients with hemifacial spasm treated by microvascular decompression were retrospectively included. The HFS-8 and HFS-30 quality of life scales were translated from English into French using a forward-backward method and implemented on patients at least one year after surgery. RESULTS Median HFS-8 and HFS-30 values were respectively 16±12.5 (range: 8-20.5) and 38±38.5 (range: 23-61.5) before surgery and 0.5±4.5 (range: 0-4.5) and 5±17.5 (range: 1-18.5) after surgery, showing significant improvement in quality of life (P<0.001). The internal consistency of both scales was excellent (Cronbach's alpha>0.9), and they were significantly correlated (Pearson coefficient=0.95; 95% CI [0.91; 0.98]; P<0.0001). Success rates were 83% and 91%, respectively, after primary and revision surgeries. Complications were transient with minor consequences in 80% of cases, but could impact quality of life when lasting. CONCLUSIONS These results support the validity of the French versions of HFS-8 and HFS-30. Microvascular decompression is a safe and effective treatment for hemifacial spasm, and these scales are reliable tools to assess postoperative quality of life.
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Affiliation(s)
- L Alciato
- Service d'oto-rhino-laryngologie, GHU Pitié-Salpêtrière, Sorbonne Université, AP-HP, DMU ChIR, GRC robotique et innovation chirurgicale, Paris, France.
| | - F Simon
- Service d'oto-rhino-laryngologie, Hôpital Necker-Enfants malades, Université de Paris, AP-HP, Paris, France
| | - R Hervochon
- Service d'oto-rhino-laryngologie, GHU Pitié-Salpêtrière, Sorbonne Université, AP-HP, DMU ChIR, GRC robotique et innovation chirurgicale, Paris, France
| | - S Trunet
- Service de neuroradiologie, GHU Pitié-Salpêtrière, AP-HP, Paris, France
| | - A Nouet
- Service de neurochirurgie, GHU Pitié-Salpêtrière, AP-HP, DMU ChIR, Paris, France
| | - F Tankéré
- Service d'oto-rhino-laryngologie, GHU Pitié-Salpêtrière, Sorbonne Université, AP-HP, DMU ChIR, GRC robotique et innovation chirurgicale, Paris, France
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Gutierrez SAS, Yu JRT, Yalung PM, Jamora RDG. Real-world experience with botulinum toxin A for the treatment of hemifacial spasm: A study of 1138 injections. Clin Neurol Neurosurg 2021; 205:106632. [PMID: 33865214 DOI: 10.1016/j.clineuro.2021.106632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/19/2021] [Accepted: 03/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hemifacial spasm (HFS) is a chronic, potentially disabling disorder that often requires long-term management with botulinum toxin (BoNT). In a country where healthcare costs limit compliance to medical follow-up and treatment, the study aims to provide a real-world experience on the use of BoNT for HFS among Filipinos. METHODS We retrospectively collected data from 162 HFS patients who received 1138 botulinum toxin (BoNT) injections from 2006 to 2019 in our movement disorders center in the Philippines. We described their clinical profile and treatment response. RESULTS The mean age at onset of disease was 47.7 ± 10.72 years. Majority of the patients reported a baseline moderate disease severity and disease frequency of >75% of waking time (59.8% and 46.9%, respectively). Most patients (61.73%) received 5 or less injections during the follow-up period. The mean duration of follow-up was 2.96 ± 4.28 years. The overall duration of treatment effect per injection was 3.6 ± 1.3 months while the mean interval between injections was 6 ± 5 months. There was no difference in the symptom improvement and duration between onabotulinumtoxinA and abobotulinumtoxinA. Side effects were infrequent. CONCLUSION This study supports existing evidence on the efficacy and safety of BoNT for the symptomatic relief of HFS. In the Philippines, long-term treatment with BoNT may be limited by the cost of the procedure as majority of our patients had a few injections with long treatment intervals.
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Affiliation(s)
- Samantha Anne S Gutierrez
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.
| | - Jeryl Ritzi T Yu
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.
| | - Patrick M Yalung
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.
| | - Roland Dominic G Jamora
- Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines; Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines; Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Philippines; Movement Disorders Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center, Global City, Philippines.
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The Five-Year Prospective Study of Quality of Life in Hemifacial Spasm Treated with Abo-Botulinum Toxin A. Toxins (Basel) 2021; 13:toxins13030215. [PMID: 33809486 PMCID: PMC7999068 DOI: 10.3390/toxins13030215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 01/22/2023] Open
Abstract
This study aimed to determine the long-term quality of life (QoL) in hemifacial spasm (HFS) patients after treating with Abo-botulinum toxin A (Abo-BTX). The study assessed the disease-specific QoL (hemifacial spasm questionnaire 30 items; HFS 30), the involuntary movements (abnormal involuntary movement scale; AIMS), general health QoL (Medical Outcomes 36-Item Short Form Health Survey; SF-36), and Depression (the Center of Epidemiologic Studies-Depression questionnaire; CES-D). A total of 74 HFS patients were enrolled from 2012 to 2017. The disease-specific QoL; involuntary movements; and the general health domain of SF 36 were significantly improved after injections of Abo-BTX A in the first few years (p < 0.04), but significantly decreased at the fifth year of treatment without significant clinical resistance observed (p < 0.001). Only the general health domain of SF 36 showed persistent improvement over five years (p = 0.02). In summary, Abo-BTX A can improved quality of life in the first few years; however only the general health domain of SF-36 showed significant improvement over five years (p = 0.02). No clinical resistance was observed.
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Herrero-Infante Y, Rodríguez-Sanz A, Máñez-Miró J, Vivancos-Matellano F. Hemifacial spasm through the last three decades: From etiology to efficacy and safety of long-term botulinum toxin treatment. Clin Neurol Neurosurg 2021; 203:106555. [PMID: 33662742 DOI: 10.1016/j.clineuro.2021.106555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 01/02/2021] [Accepted: 02/06/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hemifacial spasm (HFS) is an uncommon movement disorder characterized by involuntary contractions of muscles innervated by the facial nerve. The aim of this study is to analyze the etiology of HFS as well as the efficacy and safety of long-term botulinum toxin type A (BTX-A) treatment. METHODS Retrospective study including 125 patients with HFS treated with BTX-A from 1993 to 2019. Demographic and etiological variables as well as doses, number of sessions of BTX-A, infiltrated muscles, therapeutic response according to Patient Global Impression of Change Scale (PGIC-S), side effects and adjuvant treatments were analyzed. In addition, these variables were compared according to the etiology (idiopathic versus secondary). RESULTS 92 patients (73.6%) were women and the mean age at diagnosis was 58.63 years (SD 15.4). The etiology was idiopathic in 79 patients (63.2%), 17.6% were secondary to Bell's palsy, 14.4% to vascular compression and 2.4% to tumors. A higher total dose per session was observed in the secondary group. PGIC-S showed a good response in 96% of cases. 16 patients (12.8%) required pharmacological concomitant treatment. 59 patients (47.2%) developed side effects. Transient eyelid ptosis and facial weakness were the most common. CONCLUSIONS The structural origin of a significant number of cases of HFS makes essential to complete an etiological diagnosis in all patients. In addition, the existence of a secondary cause could be associated with greater doses of BTX-A to achieve a good response. Regardless the etiology, long-term treatment with BTX-A in HFS is safe and effective.
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Affiliation(s)
- Yolanda Herrero-Infante
- Movement Disorders Unit, Neurology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain.
| | - Ana Rodríguez-Sanz
- Movement Disorders Unit, Neurology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - Jorge Máñez-Miró
- Movement Disorders Unit, Neurology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - Francisco Vivancos-Matellano
- Movement Disorders Unit, Neurology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
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Girard B, de Saint Sauveur G, Tatry M, Abdellaoui M, Tassart M. [Hemifacial spasm. Etiology and management]. J Fr Ophtalmol 2020; 44:382-390. [PMID: 33390255 DOI: 10.1016/j.jfo.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/19/2020] [Accepted: 08/11/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hemifacial spasm (HFS) is an involuntary contracture of the facial muscles innervated by the ipsilateral facial nerve. We studied the etiology of these HFS. MATERIALS AND METHODS This retrospective study included 233 patients with HFS who came to the ophthalmologist for quarterly botulinum neurotoxin A injection. Of these, we analyzed the 198 patients for whom MRI scans were performed. We recorded patient clinical data and clarified the etiology of their HFS. RESULTS The 198 patients (62.6% women) had a mean age of 55.7±14years. An etiology was found in 52.5% of cases. In 34.5% of HFS, MRI revealed vascular compression where the facial nerve emerged from the brainstem. We specify the arteries involved. Brain tumors accounted for 1.5% of cases. MRI was normal in 64.5% of cases. In these secondary cases of HFS, we found 8.5% peripheral facial palsy, 4% post-traumatic HFS and 4% secondary to an eye injury. Stress was found in 17% of patients. DISCUSSION AND CONCLUSION This study illustrates the need for MRI with attention to the posterior fossa in the work-up of HFS in order to identify primary HFS associated with vascular compression of the facial nerve and to rule out a rare but serious posterior fossa tumor. The treatment of HFS is based on quarterly injections of botulinum neurotoxin/A (NTBo/A), the three brands of which have market approval. The injection pattern and frequency is customized according to the results. In cases of insufficient response to injections of NTBo/A, neurosurgical microvascular decompression may be considered for cases of primary HFS.
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Affiliation(s)
- B Girard
- Service d'ophtalmologie, hôpital Tenon, Sorbonne université, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France.
| | - G de Saint Sauveur
- Service d'ophtalmologie, hôpital Tenon, université Paris-Descartes, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - M Tatry
- Service d'ophtalmologie, hôpital Tenon, Sorbonne université, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - M Abdellaoui
- Service d'ophtalmologie, hôpital Tenon, Sorbonne université, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - M Tassart
- Service de radiologie, hôpital Tenon, Sorbonne université, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France
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Luo FF, Xu H, Zhang M, Wang Y. Abnormal Regional Spontaneous Brain Activity and Its Indirect Effect on Spasm Ratings in Patients With Hemifacial Spasm. Front Neurosci 2020; 14:601088. [PMID: 33362459 PMCID: PMC7756088 DOI: 10.3389/fnins.2020.601088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Three classical methods of resting-state functional magnetic resonance imaging (rs-fMRI) were employed to explore the local functional abnormalities and their effect on spasm ratings in hemifacial spasm (HFS) patients. METHODS Thirty HFS patients and 30 matched healthy controls (HCs) were recruited. Rs-fMRI data, neurovascular compression (NVC) degree and spasm severity were collected in each subject. Fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and degree centrality (DC) were calculated in the whole brain voxels. Two sample t-tests were performed to investigate group differences of fALFF, ReHo, and DC. Correlation analysis was performed to assess the relationships between the regional brain abnormalities and clinical variables in HFS. RESULTS Compared with HCs, HFS patients exhibited increased fALFF in the left precuneus and right posterior cingulate cortex (PCC), together with increased ReHo in the bilateral PCC and bilateral precuneus. Decreased ReHo was observed in the right middle occipital gyrus (MOG), right superior occipital gyrus (SOG), right cuneus, and right angular gyrus (AG) in HFS patients. Moreover, ReHo in the right PCC were positively correlated with NVC degree and spasm severity in HFS patients, respectively. Mediation analysis revealed that increased ReHo in the right PCC regulated the neurovascular compression degree, and further resulted in increased spasm ratings. CONCLUSION Our study revealed regional brain dysfunctions from different perspectives and an indirect effect of ReHo in right PCC on spasm ratings predominantly through the alteration of NVC.
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Affiliation(s)
- Fei-Fei Luo
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Hui Xu
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ming Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yuan Wang
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Duarte GS, Rodrigues FB, Castelão M, Marques RE, Ferreira J, Sampaio C, Moore AP, Costa J. Botulinum toxin type A therapy for hemifacial spasm. Cochrane Database Syst Rev 2020; 11:CD004899. [PMID: 33211908 PMCID: PMC8078498 DOI: 10.1002/14651858.cd004899.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This is an update of a Cochrane Review, first published in 2005. Hemifacial spasm (HFS) is characterised by unilateral, involuntary contractions of the muscles innervated by the facial nerve. It is a chronic disorder, and spontaneous recovery is very rare. The two treatments routinely available are microvascular decompression and intramuscular injections with botulinum toxin type A (BtA). OBJECTIVES To compare the efficacy, safety, and tolerability of BtA versus placebo in people with HFS. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, reference lists of articles, and conference proceedings in July 2020. We ran the electronic database search, with no language restrictions, in July 2020. SELECTION CRITERIA Double-blind, parallel, randomised, placebo-controlled trials (RCTs) of BtA versus placebo in adults with HFS. DATA COLLECTION AND ANALYSIS Two review authors independently assessed records. We planned to select included studies, extract data using a paper pro forma, and evaluate the risk of bias. We resolved disagreements by consensus, or by consulting a third review author. We planned to perform meta-analyses. The primary efficacy outcome was HFS-specific improvement. The primary safety outcome was the proportion of participants with any adverse event. MAIN RESULTS We found no parallel-group randomised controlled trials comparing BtA and placebo in HFS. AUTHORS' CONCLUSIONS We did not find any randomised trials that evaluated the efficacy and safety of botulinum toxin type A in people with hemifacial spasm, so we are unable to draw any conclusions. Observational data show a strong association between BtA treatment and symptom improvement, and a favourable safety profile. While it is unlikely that future placebo-controlled RCTs will evaluate absolute efficacy and safety, they should address relevant questions for both people with HFS (such as long-term effects, quality of life, and other patient-reported outcomes), and clinicians (such as relative effectiveness of different BtA formulations and schemes of treatment) to better guide clinical practice.).
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Affiliation(s)
- Gonçalo S Duarte
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Filipe B Rodrigues
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Mafalda Castelão
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Raquel E Marques
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Ophthalmology University Clinic, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Joaquim Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | | | | | - João Costa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
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Compagnon C, Labrousse M, Brenet E, Chays A, Bazin A, Kleiber JC, Dubernard X. Efficacy and Complications of Microsurgical Neurovascular Decompression in 55 Patients With Hemifacial Spasm. Otolaryngol Head Neck Surg 2020; 164:1299-1306. [PMID: 33198570 DOI: 10.1177/0194599820969168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyze the efficacy and complications of microvascular decompression for hemifacial spasm. STUDY DESIGN Retrospective study. SETTING Regional hospital. METHODS Fifty-five patients with hemifacial spasm were treated by microvascular decompression. All patients with hemifacial spasm who underwent retrosigmoid microvascular decompression from May 2004 to January 2017 were included. Patients with no conflict on preoperative magnetic resonance imaging or with an alternate diagnosis were excluded. RESULTS The overall cure rate was 83.64%, with an average follow-up of 7.4 years. A left-sided hemifacial spasm was a healing-promoting factor (P = .01). The median healing was 0.03 months, and the mean was 6 months. The efficacy remained high in the medium term (88% at 3 years), long term (90.24% at 5 years), and very long term (90.48% at 8 years). The recurrence rate was 9.8%. Favorable criteria included a right-sided spasm (P = .01) and an average age of 62 years (P = .03). The specific complications were permanent facial palsy (3.63%), unilateral deafness (5.45%), and hearing loss (3.63%). No death was reported. Regarding the quality of life of the patients, 94.7% had a modified HFS-8 postoperative score of 0 (Hemifacial Spasm 8 Quality of Life Scale). CONCLUSION Microvascular decompression for hemifacial spasm is an effective and lasting technique. Its low rate of complications and the considerable quality-of-life improvement should lead surgeons to propose it to patients as soon as botulinum toxin injections become ineffective or poorly tolerated.
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Affiliation(s)
- Chloé Compagnon
- Department of Otorhinolaryngology, Head and Neck Pole, Robert Debré Hospital, Reims University Hospital, Grand Est Region, France
| | - Marc Labrousse
- Department of Otorhinolaryngology, Head and Neck Pole, Robert Debré Hospital, Reims University Hospital, Grand Est Region, France
| | - Esteban Brenet
- Department of Otorhinolaryngology, Head and Neck Pole, Robert Debré Hospital, Reims University Hospital, Grand Est Region, France
| | - André Chays
- Department of Otorhinolaryngology, Head and Neck Pole, Robert Debré Hospital, Reims University Hospital, Grand Est Region, France.,Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Department, Maison Blanche Hospital, Reims University Hospital, Grand Est Region, France
| | - Arnaud Bazin
- Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Department, Maison Blanche Hospital, Reims University Hospital, Grand Est Region, France.,Department of Neurosurgery, Head and Neck Department, Maison Blanche Hospital, Reims University Hospital, Grand Est Region, France
| | - Jean-Charles Kleiber
- Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Department, Maison Blanche Hospital, Reims University Hospital, Grand Est Region, France.,Department of Neurosurgery, Head and Neck Department, Maison Blanche Hospital, Reims University Hospital, Grand Est Region, France
| | - Xavier Dubernard
- Department of Otorhinolaryngology, Head and Neck Pole, Robert Debré Hospital, Reims University Hospital, Grand Est Region, France.,Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Department, Maison Blanche Hospital, Reims University Hospital, Grand Est Region, France
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Zhong Z, Xiong J, Lu L, Chen J, Tang G, Zhu S, Zhou X, Guo H. Efficacy of fire needle on patients of facial spasm: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e22731. [PMID: 33120772 PMCID: PMC7581102 DOI: 10.1097/md.0000000000022731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Facial spasm causes a lot of troubles to patients daily life and seriously affects their mental and physical health. Relevant studies have shown that fire needle therapy has certain benefits for facial spasm, is an integral part of acupuncture therapy. However, there is no unanimous conclusion. The main purpose of our study is to measure whether fire needle therapy is effective for facial spasm. METHODS The following electronic databases will be searched for the collection of fire-needle related randomized controlled trials (RCTS) for facial spasm, including 4 English databases (Web of Science, the Cochrane Library, EMBASE, Pubmed) and 3 Chinese databases (Chinese National Knowledge Infrastructure [CNKI], Wanfang data, Chinese VIP Information). The cure rate and total effective rate are the main outcomes, while the intensity, frequency, recurrence rate and adverse events are the secondary outcomes. We will use Endnote software X9 for study selection, Review Manager software 5.4 and STATA 13.0 software for analysis and synthesis. RESULTS We will evaluate the efficacy of fire needles in the treatment of facial spasm in combination with current studies. CONCLUSION The conclusion of this study will provide evidence for the efficacy of fire needle in the treatment of facial spasm. TRIAL REGISTRATION NUMBER INPLASY202080036.
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Affiliation(s)
- Zhiying Zhong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine
| | - Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine
| | - Lunbin Lu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jun Chen
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Genhua Tang
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Siyuan Zhu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xingchen Zhou
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Han Guo
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Matmusaev M, Kumar RS, Yamada Y, Nagatani T, Kawase T, Tanaka R, Kyosuke M, Kato Y. Endoscopic Microvascular Decompression for Hemifacial Spasm. Asian J Neurosurg 2020; 15:833-838. [PMID: 33708651 PMCID: PMC7869256 DOI: 10.4103/ajns.ajns_152_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/02/2020] [Accepted: 05/28/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction and Objective Hemifacial spasm (HFS) is a condition, characterized by painless, involuntary unilateral tonic or clonic contractions of the facial muscles innervated by the ipsilateral facial nerve. HFS starts with contractions in the orbicularis oculi muscle with subsequent eyelid closure and/or eyebrow elevation, but may spread to involve muscles of the frontalis, platysma, and orbicularis oris muscles. Microvascular decompression (MVD) is reliable and accepted surgical treatment for HFS. MVD is the standard surgical technique now for HFS treatment with long-term success rates. Materials and Methods We performed fully endoscopic MVD technique for 1 patient with HFS (a 83-year-old female) at our institution. HFS was diagnosed based on the clinical history and presentation, a neurologic examination, and additional imaging findings. Respectively, the durations of HFS were 3 years, respectively. The patient had been previously treated with repeated botulinum toxin injections. Preoperative evaluation was done with magnetic resonance imaging; three-dimensional computed tomography fusion images examinations had identified the anterior inferior cerebellar artery (AICA) as the offending vessel in this patient. Results The patient with HFS was treated by fully endoscopic MVD technique. The AICA, which had been identified as the offending vessel by preoperative magnetic resonance imaging, was successfully decompressed. No surgery-related complications occurred and had excellent outcomes with the complete resolution of HFS immediately after the operation. Conclusions Endoscopic surgery can provide a more panoramic surgical view than conventional microscopic surgery. Fully endoscopic MVD is both safe and effective in the treatment of HFS. This method minimizes the risks of brain retraction and extensive dissection often required for microscopic exposure. Endoscopic MVD is safe and has advantage over microscope in terms of visualization of structure, identification of neurovascular conflict, but it has a learning curve and technically challenging.
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Affiliation(s)
- Maruf Matmusaev
- Republican Specialized Scientific and Practical Medical Center of Neurosurgery, Tashkent, Uzbekistan
| | - R Senthil Kumar
- Department of Neurosurgery, Royal Care Super Speciality Hospital, Coimbatore, Tamil Nadu, India
| | - Yasuhiro Yamada
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
| | - Tetsuya Nagatani
- Department of Neurosurgery, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Tsukasa Kawase
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
| | - Riki Tanaka
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
| | - Miyatani Kyosuke
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
| | - Yoko Kato
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan
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