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Anudeep DDS, Karthik K, Holla VV, Kamble N, Yadav R, Pal PK, Mahale RR. Ventrolateral medullary compression by vascular contact in primary hemifacial spasm: a radiological analysis. Neurol Sci 2024:10.1007/s10072-024-07602-9. [PMID: 38789836 DOI: 10.1007/s10072-024-07602-9] [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: 03/29/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND The neurovascular conflict (NVC) causing hemifacial spasm (HFS) can also cause compression of ventrolateral medulla (VLM) which contains the central sympathetic neurons. VLM compression has been associated with hypertension. Whether the VLM compression in HFS patients is associated with hypertension is not clear. OBJECTIVE To determine the frequency, severity of VLM compression and its association with hypertension in HFS patients. METHODS A cross-sectional, hospital-based, case control study and recruited 120 study subjects (50 cases of primary HFS, 30 hypertensive and 40 normotensive age-, sex- matched controls). The VLM compression was assessed in magnetic resonance imaging Constructive Interference in Steady State (CISS) 3D sequences. RESULTS Hypertension was present in 30 cases (60%). Six patients with HFS (20%) were detected to be hypertensive after the onset of HFS. VLM compression was seen in 24 cases (48%), 7 hypertensive controls (23.3%) and 5 normotensive controls (10%) (p = 0.03). Twenty-four patients with hypertension had VLM compression and remaining 6 patients with hypertension did not have VLM compression (80% vs 20%; p = 0.02). Normotensive patients did not have VLM compression. Vertebral artery was the most common artery causing VLM compression (22 patients; 7 hypertensive and 5 normotensive controls). CONCLUSION VLM compression is more common in HFS patients as compared to hypertensive and normotensive controls. It is more common in hypertensive HFS patients in comparison with normotensive HFS patients. Microvascular decompression is an option in hypertensive HFS patients with VLM compression if the hypertension is medically refractory.
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Affiliation(s)
- D D S Anudeep
- Department of Neurology, National Institute of Mental Health and Neurosciences, First Floor, Neurosciences Faculty Block, Hosur Road, Bangalore, 560029, Karnataka, 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, First Floor, Neurosciences Faculty Block, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, First Floor, Neurosciences Faculty Block, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, First Floor, Neurosciences Faculty Block, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, First Floor, Neurosciences Faculty Block, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Rohan R Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences, First Floor, Neurosciences Faculty Block, Hosur Road, Bangalore, 560029, Karnataka, India.
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Xiao Y, He J. Analyzing the application of dezocine combined with psychological care in the postoperative pain management of patients with hemifacial spasm. Int J Neurosci 2024:1-8. [PMID: 38602339 DOI: 10.1080/00207454.2024.2341919] [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: 02/27/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE To analyze the application of Dezocine combined with psychological care in the postoperative pain management. METHODS This is a retrospective study. A total of 186 HFS patients who underwent Microvascular Decompression (MVD) at First People's Hospital of Zunyi between January 2020 and January 2022 were selected as the study subjects. Patients were divided into two groups based on different treatment interventions. The control group (n = 93) received routine perioperative care without preemptive analgesia, while the observation group (n = 93) received preemptive analgesia and combined psychological care on the basis of the control group's intervention. RESULTS At 30 min post-laryngeal mask removal (T3), no significant difference in Ramsay Sedation Scale scores existed between control and observation groups (p > 0.05). The observation group showed significantly lower RSS scores at immediate mask removal (T2) and VAS scores at T3 compared to controls (p < 0.05). Following intervention, the observation group had notably lower SAS and SDS scores than controls (p < 0.05). Baseline (T0) and 5 min pre-removal (T1) exhibited no significant differences in mean arterial pressure (MAP) and heart rate (HR) values between groups (p > 0.05). However, at T2 and T3, the observation group displayed significantly lower MAP and HR values than controls (p < 0.05). No significant differences in pulse oxygen saturation (SpO2) values existed between groups at any time point (p > 0.05). CONCLUSION Compared to standard perioperative care alone, Dezocine combined with preemptive analgesia and psychological care effectively reduces postoperative pain during the awakening period, lowers the risk of immediate extubation-related agitation, and maintains stable hemodynamics in the postoperative period.
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Affiliation(s)
- Ying Xiao
- Department of Neurosurgery, First People's Hospital of Zunyi City, Guizhou Province, China
| | - Jiqiong He
- Department of Stomatology, First People's Hospital of Zunyi City, Guizhou Province, China
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Kościołek D, Kobierecki M, Tokarski M, Szalbot K, Kościołek A, Malicki M, Wanibuchi S, Wiśniewski K, Piotrowski M, Bobeff EJ, Szmyd BM, Jaskólski DJ. The Anterior Inferior Cerebral Artery Variability in the Context of Neurovascular Compression Syndromes: A Narrative Review. Biomedicines 2024; 12:452. [PMID: 38398054 PMCID: PMC10887044 DOI: 10.3390/biomedicines12020452] [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: 01/24/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
The anterior inferior cerebellar artery (AICA) is situated within the posterior cranial fossa and typically arises from the basilar artery, usually at the pontomedullary junction. AICA is implicated in various clinical conditions, encompassing the development of aneurysms, thrombus formation, and the manifestation of lateral pontine syndrome. Furthermore, owing to its close proximity to cranial nerves within the middle cerebellopontine angle, AICA's pulsatile compression at the root entry/exit zone of cranial nerves may give rise to specific neurovascular compression syndromes (NVCs), including hemifacial spasm (HFS) and geniculate neuralgia concurrent with HFS. In this narrative review, we undertake an examination of the influence of anatomical variations in AICA on the occurrence of NVCs. Significant methodological disparities between cadaveric and radiological studies (CTA, MRA, and DSA) were found, particularly in diagnosing AICA's absence, which was more common in radiological studies (up to 36.1%) compared to cadaver studies (less than 5%). Other observed variations included atypical origins from the vertebral artery and basilar-vertebral junction, as well as the AICA-and-PICA common trunk. Single cases of arterial triplication or fenestration have also been documented. Specifically, in relation to HFS, AICA variants that compress the facial nerve at its root entry/exit zone include parabola-shaped loops, dominant segments proximal to the REZ, and anchor-shaped bifurcations impacting the nerve's cisternal portion.
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Affiliation(s)
- Dawid Kościołek
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Mateusz Kobierecki
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Mikołaj Tokarski
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Konrad Szalbot
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Aleksandra Kościołek
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Mikołaj Malicki
- Medical Faculty, Medical University of Lodz, Kosciuszki St., 90-419 Lodz, Poland; (D.K.); (M.K.); (M.T.); (K.S.); (A.K.); (M.M.)
| | - Sora Wanibuchi
- The Faculty of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
| | - Karol Wiśniewski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
| | - Michał Piotrowski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
| | - Ernest J. Bobeff
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Mazowieka St. 6/8, 92-251 Lodz, Poland
| | - Bartosz M. Szmyd
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna St. 36/50, 91-738 Lodz, Poland
| | - Dariusz J. Jaskólski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (M.P.); (E.J.B.); (D.J.J.)
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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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Walker C. Unilateral periocular spasm. JAAPA 2024; 37:1-4. [PMID: 38270661 DOI: 10.1097/01.jaa.0000995640.85221.b0] [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: 01/26/2024]
Abstract
ABSTRACT Hemifacial spasm is an uncontrollable, recurrent facial muscular contraction that typically occurs on one side of the face, cannot be suppressed, and can last the entire day and during sleep. The most common underlying cause of facial nerve compression is an enlarged or abnormal tracking blood vessel at the brainstem level. Clinical diagnoses are frequently based on a patient's medical history and physical examination. Before deciding on a course of action, however, an electromyogram and MRI are performed to determine the underlying cause. Due to its high effectiveness (success rates of 85% to 95%) and low frequency of adverse reactions, botulinum toxin is the preferred therapy for hemifacial spasm and can provide transient symptomatic alleviation. Surgical microvascular decompression is a therapeutic approach that targets the underlying cause of this condition and has an average success rate of 85%.
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Affiliation(s)
- Clay Walker
- Clay Walker practices in family medicine at the Mayo Clinic in Phoenix, Ariz., and is an adjunct faculty member in the PA programs at Southern Illinois University in Carbondale, Ill., Rush University in Chicago, Ill., A.T. Still University in Mesa, Ariz., and Franklin Pierce University in Rindge, N.H. The author has disclosed no potential conflicts of interest, financial or otherwise
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Alkhayri A, Bourdillon P, Chauvet D, Bugdadi A, Alyousef M, Alsalmi S, Apra C, Lefaucheur JP, Aldea S, Le Guérinel C. Surgical treatment of hemifacial spasms: how to predict failure and complications through a series of 200 patients. Neurochirurgie 2023; 69:101498. [PMID: 37741362 DOI: 10.1016/j.neuchi.2023.101498] [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: 04/12/2023] [Revised: 08/16/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
Primary hemifacial spasm (pHFS) is a benign but disabling movement disorder caused by a neurovascular conflict involving the facial nerve. Surgical treatment by microvascular decompression (MVD) is the most effective therapeutic. Predictors of surgical failure and surgical complications are still lacking. The aim of this study is to identify such predictors through the retrospective analysis of a series of 200 consecutive patients. All patients who underwent MVD for pHFS from January 1991 to December 2017 were included. All patients had at least two years follow-up. In addition to the demographic data, the outcome and the complications were collected. The primary outcome analysis showed that 7.5% of patients had a recurrence. Multiple and AICA related neurovascular conflicts were statistically associated to a higher recurrence rate after MVD (respectively p < 0.001 and p = 0.02). Permanent facial palsy occurred in 2.5% of patients, hearing loss in 9.0% (2.0% of complete unilateral impairment) and dizziness in 2.5%. The risk of each of these peripheral neurological impairments was statistically increased by a long duration between the first pHFS symptom and the MVD (p < 0.001). In case of recurrence, a second MDV was offered. Long term follow-up showed that all patients had a complete resolution of the HFS. Post-operative complication rate was not significantly increased after a second MVD. Multiple and AICA related neurovascular conflicts are associated to a higher risk of surgical failure. When a pHFS recurrence occurs, a second surgical procedure is associated with excellent outcome without significant increase of post-operative complications and should therefore be recommended.
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Affiliation(s)
- Abdu Alkhayri
- Department of Neurosurgery, Rothschild Foundation Hospital, Paris, France; Paris Cité University, Faculty of Medicine, Paris, France
| | - Pierre Bourdillon
- Department of Neurosurgery, Rothschild Foundation Hospital, Paris, France; Paris Cité University, Faculty of Medicine, Paris, France.
| | - Dorian Chauvet
- Department of Neurosurgery, Rothschild Foundation Hospital, Paris, France
| | - Abdulgadir Bugdadi
- Department of Surgery, Faculty of Medicine, Umm Al Qura University, Makkah, Almukarramah, Saudi Arabia
| | - Mohammed Alyousef
- Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sultan Alsalmi
- Department of Neurosurgery, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Caroline Apra
- Department of Neurosurgery, Rothschild Foundation Hospital, Paris, France; Sorbonne University, Faculty of Medicine, Paris, France
| | - Jean-Pascal Lefaucheur
- Department of Neuro-physiology, Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France; University of Paris-Est, Paris, France
| | - Sorin Aldea
- Department of Neurosurgery, Rothschild Foundation Hospital, Paris, France
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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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Yamakawa K, Nishijima H, Kubota A, Naruse H, Baba S, Fujimaki Y, Kondo K, Toda T, Yamasoba T. Clinical and electrophysiological findings of facial palsy in a case of hereditary gelsolin amyloidosis. Auris Nasus Larynx 2023; 50:305-308. [PMID: 35241298 DOI: 10.1016/j.anl.2022.02.003] [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: 01/02/2022] [Revised: 01/31/2022] [Accepted: 02/13/2022] [Indexed: 11/26/2022]
Abstract
Hereditary gelsolin amyloidosis (HGA) is an autosomal dominant systemic amyloidosis, characterized by cranial and sensory peripheral neuropathy, corneal lattice dystrophy, and cutis laxa. We report a case of HGA presenting with bilateral facial palsy. A 70-year-old Japanese man presented with slowly progressive bilateral facial palsy and facial twitching, which had started in his 40s. His mother also had the same symptoms due to an unknown cause but rest of the family did not. He showed incomplete facial palsy with no frontal muscle movement and partial movement of the orbicularis oris and orbicularis oculi muscles. The patient showed no synkinesis. Electroneurography revealed symmetric low compound motor action potential amplitude of the orbicularis oris muscle, and a nerve excitability test showed a symmetric increase in the response threshold. Despite the partial voluntary movement of the orbicularis oculi muscle, bilateral blink reflexes were absent. He also showed facial spasms after contraction of the orbicularis oris muscle. Genetic testing revealed a heterozygous c.640G>A mutation (p. Asp214Asn); therefore, the patient was diagnosed with HGA. HGA related facial palsy showed moderate bilateral, upper blanch-dominant axonal degeneration of the facial nerve without reinnervation, and trigeminal nerve neuropathy.
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Affiliation(s)
- Kaoru Yamakawa
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan.
| | | | - Akatsuki Kubota
- Department of Neurology, The University of Tokyo, Tokyo, Japan
| | - Hiroya Naruse
- Department of Neurology, The University of Tokyo, Tokyo, Japan
| | - Shintaro Baba
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan
| | - Yoko Fujimaki
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan
| | - Kenji Kondo
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan
| | - Tatsushi Toda
- Department of Neurology, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan
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Brain White Matter Structural Alteration in Hemifacial Spasm: A Diffusion Tensor Imaging Study. J Craniofac Surg 2023; 34:674-679. [PMID: 36730451 DOI: 10.1097/scs.0000000000009083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/22/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To analyze the changes in the white matter structure of the whole brain in hemifacial spasm (HFS) patients by using the tract-based spatial statistics (TBSS) method. MATERIALS AND METHODS 29 HFS patients without anxiety and depression and 29 healthy controls with matching age, sex, and education were selected. All subjects received a 3.0T magnetic resonance (MR) brain diffusion tensor imaging scan. Tract-based spatial statistics method was used to analyze the changes in white matter structure in the whole brain and obtained the cerebral white matter fibrous areas exhibiting significant intergroup differences. The fractional anisotropy (FA), mean diffusivity, axial diffusivity, and radial diffusivity of these areas were abstracted. Analyzed the correlation between these diffusion metrics and clinical variables (disease duration, spasm severity). RESULTS Compared with the healthy controls group, the HFS group exhibited significantly lower FA in the forceps minor, bilateral anterior thalamic radiation, and right superior longitudinal fasciculus ( P <0.05, threshold-free cluster enhancement corrected). Cohen grading scale of HFS patients was negatively correlated with FA of forceps minor. CONCLUSION Based on TBSS analysis, the injury of white matter fiber tracts in HFS patients was found, including forceps minor, bilateral anterior thalamic radiation, and right superior longitudinal fasciculus. The changes of FA values in forceps minor were negatively correlated with the Cohen grading scale, suggesting that the alteration of white matter fiber in the genu-of-corpus-callosum-cortex circuit plays an important role in the neuro-pathological mechanism of HFS. Combined with previous research, it is also necessary to further explore the change of the superior longitudinal fasciculus in the future.
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Nakamura K, Kuge A, Yamaki T, Sano K, Saito S, Kondo R, Sonoda Y. Endovascular Treatment of Hemifacial Spasm Associated with a Tentorial DAVF Using Transarterial Onyx Embolization: A Case Report. JOURNAL OF NEUROENDOVASCULAR THERAPY 2022; 16:523-528. [PMID: 37502204 PMCID: PMC10370818 DOI: 10.5797/jnet.cr.2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/15/2022] [Indexed: 07/29/2023]
Abstract
Objective We describe a patient treated with transarterial Onyx embolization for a tentorial dural arteriovenous fistula (DAVF) who presented with hemifacial spasm (HFS). Case Presentation A 56-year-old man suffered from right blepharospasm for 4 years, and the symptom gradually spread to the right side of his face with oculo-oral synkinesis. MRI of the brain revealed abnormal multiple flow voids at the surface of brainstem and cerebellar hemisphere. MRA (time of flight) and spoiled gradient recalled echo-revealed abnormal vessels at the posterior fossa indicated arteriovenous shunting. 3D-MRI fusion images showed that a dilated vein was in contact with the root exit zone (REZ) of the right facial nerve. The right carotid angiography displayed a complex tentorial DAVF on the right side. There were multiple feeding vessels drained to the tentorial sinus at the point where the inferior cerebellar vermian vein met, and severe venous congestion was noted. We diagnosed a tentorial DAVF and thought that this was responsible for the right HFS. We used neuroendovascular treatment for this lesion. After transarterial Onyx embolization, his right HFS diminished. MRI after treatment showed that the vein in contact with the REZ of the right facial nerve had shrank. Conclusion We experienced a rare case of HFS associated with a DAVF. Our case supports that transarterial Onyx embolization can treat HFS associated with a tentorial DAVF. It is the first description of successful treatment that could be confirmed through postoperative MRI.
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Affiliation(s)
- Kazuki Nakamura
- Stroke Center, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
| | - Atsushi Kuge
- Stroke Center, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
- Department of Emergency Medicine, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
| | - Tetsu Yamaki
- Stroke Center, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
| | - Kenshi Sano
- Stroke Center, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
| | - Shinjiro Saito
- Stroke Center, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
| | - Rei Kondo
- Stroke Center, Yamagata City Hospital Saiseikan, Yamagata, Yamagata, Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata, Yamagata, Japan
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Shi X, Zhang X, Xu L, Xu Z. Neurovascular Compression Syndrome:Trigeminal neuralgia, Hemifacial spasm, Vestibular paroxysmia, Glossopharyngeal neuralgia, four case reports and review of literature. Clin Neurol Neurosurg 2022; 221:107401. [DOI: 10.1016/j.clineuro.2022.107401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/02/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022]
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Factors Related to Hemifacial Spasm Recurrence in Patients Undergoing Microvascular Decompression—A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:brainsci12050583. [PMID: 35624968 PMCID: PMC9139130 DOI: 10.3390/brainsci12050583] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022] Open
Abstract
There is a lack of knowledge about the factors associated with the recurrence of hemifacial spam (HFS) following an initially successful microvascular decompression (MVD) surgery. The aim of the present study was to systematically review the pertinent literature and carry out a meta-analysis of factors linked to HFS recurrence in patients undergoing initially successful MVD treatment. An online literature search was launched on the PubMed/Medline and Scopus databases. The following data were collected: sex, age at surgery, affected side, reported improvement after surgery, presence of post-operatory facial weakness, symptom duration, offender vessels, and data obtained from intraoperative neurophysiological monitoring. Upon full-text review, eight articles were included, studying 1105 patients, of which 64 (5.7%) reported recurrence after MVD surgery for hemifacial spasm. There was a statistically significant increased incidence of HFS recurrence in patients with the persistence of lateral spread response (LSR after surgery (OR 9.44 (95% CI 1.69–52.58) p 0.01), while those patients experiencing a shorter disease duration before going to surgery were significantly less prone to experiencing disease recurrence (OR 0.11 (95% CI 0.03–0.46) p 0.002). The remaining examined factors did not result as significantly associated with the risk of recurrence. The funnel plots were largely symmetrical for each variable studied. Taken together, the results of our meta-analysis seem to suggest that short-term symptom duration is a protective factor against HFS recurrence after MVD surgery, while LSR persistence is a negative prognostic factor. Well-designed randomized controlled clinical trials with a long follow-up are expected to further explore therapeutic alternatives for HFS recurrence.
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Abstract
Symmetry of the face is one of the most important features for the perception of attractiveness. Asymmetry of the face means that the right and left sides of the face are not identical. Subclinical facial asymmetry is very common in the general population. Most people have some slight facial asymmetry, and this is the normal biological situation in humans. Abnormalities from soft tissue, dental, and skeletal elements lead to facial asymmetry. Asymmetry has many causal factors, and its aetiology includes both congenital and acquired conditions. Neurological facial asymmetry is scarcely addressed in the dental literature. In this narrative review, we focus on the most common neurological causes of facial asymmetry. From a neurological point of view, facial asymmetry can result from disturbances of the cranial nerves, developmental disorders, or myopathies. In the broad range of differential diagnostics of facial asymmetry, neurological abnormalities should be taken into consideration. The treatment must be related to the underlying cause. Complete knowledge of the aetiological factors and the character of the asymmetry plays a crucial role in formulating a treatment plan.
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Can hemifacial spasm lead to glaucomatous changes? J Fr Ophtalmol 2022; 45:504-510. [DOI: 10.1016/j.jfo.2021.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 11/20/2022]
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Akulov MA, Shimansky VN, Orlova OR, Zakharov VO, Shevchenko KV, Ogurtsova AA, Orlova AS. [Higher efficacy of botulinum toxin therapy for hemifacial spasm recurrence after vascular decompression. Case report and literature review]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2022; 86:89-96. [PMID: 35412717 DOI: 10.17116/neiro20228602189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hemifacial spasm (HFS) is an involuntary synchronous tonic and/or clonic contraction of mimic muscles following ipsilateral facial nerve dysfunction. The last one is a result of neurovascular conflict between the facial nerve and vessel. Currently, vascular decompression is a pathogenetic treatment modality for primary HFS. Various authors describe postoperative recurrence of HFS, and botulinum toxin therapy remains the only option for these patients. We aimed to describe the efficacy of botulinum toxin therapy in patients with HFS recurrence after surgical vascular decompression. The article presents a female patient with a long-term history of HFS and botulinum toxin therapy (with different formulations). Efficacy of therapy gradually decreased (progressive reduction of intervals between injections). MRI revealed a close relationship between posterior inferior cerebellar artery and roots of acoustic-facial nerves near the brainstem. The patient underwent vascular decompression of the left facial nerve root under intraoperative monitoring with positive postoperative outcome. However, HFS symptoms recurred in 3 days after surgery. Botulinum toxin type A (BTA) injections were resumed with significant positive effect that can be explained by reduction of one of the factors involved into HFS. Thus, patients with HFS recurrence after vascular decompression may benefit from BTA therapy.
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Affiliation(s)
- M A Akulov
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - O R Orlova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | | | - A S Orlova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Zhou J, Jiang L, Yuan S, Huang J, Shi Q, Xie Y, Deng B, Zhan Y. Association Study of Apolipoprotein E Gene Polymorphism With Incidence and Delayed Resolution of Hemifacial Spasm. Front Neurol 2021; 12:760126. [PMID: 34975724 PMCID: PMC8714662 DOI: 10.3389/fneur.2021.760126] [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: 08/17/2021] [Accepted: 11/18/2021] [Indexed: 11/26/2022] Open
Abstract
Objective: This study investigates the correlation between Apolipoprotein E gene (APOE) polymorphism and the incidence and delayed resolution of hemifacial spasms. Methods: The APOE genotypes of 151 patients with hemifacial spasm and 73 control cases were determined by cleaved amplification polymorphism sequence-tagged sites. The distribution of three APOE alleles (ε2, ε3, and ε4) in two groups and the delayed resolution rate in 6 genotypes were calculated and statistically analyzed. Results: The proportion of patients with APOE ε3/ε4 genotype in the hemifacial spasm group (25.17%) was significantly higher than that in the control group (12.33%) (P = 0.027). In terms of allele frequency, the proportion of the APOE ε4 allele in the hemifacial spasm group (15.56%) was significantly higher than that in the control group (6.85%) (P = 0.009). Meanwhile, the proportion of APOE ε4 allele carriers in the hemifacial spasm group (29.80%) was significantly higher than that in the control group (13.7%) (P = 0.009). Logistic regression analysis showed that the ε4 allele significantly increased the incidence of hemifacial spasm (OR 2.675, 95%CI 1.260-5.678, P = 0.010). Among the 32 patients with a delayed resolution, the ε3/ε3 and ε3/ε4 had the highest proportion in 6 genotypes. The delayed resolution rate of APOE ε3/ε4 (34.21%) was significantly higher than APOE ε3/ε3 (17.78%) (P < 0.05). The delayed resolution rate of APOE ε4 carriers was the highest (33.33%) in the 3 allele carriers, but there was no significant difference among the 3 allele carriers (P = 0.065). Conclusion: The polymorphism of APOE is relevant to the incidence rate of hemifacial spasms. APOE ε4 allele increases the incidence of hemifacial spasm. The APOE ε4 allele may promote the occurrence of delayed resolution.
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Tambasco N, Filidei M, Nigro P, Parnetti L, Simoni S. Botulinum Toxin for the Treatment of Hemifacial Spasm: An Update on Clinical Studies. Toxins (Basel) 2021; 13:toxins13120881. [PMID: 34941718 PMCID: PMC8706367 DOI: 10.3390/toxins13120881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Hemifacial spasm (HFS) is a movement disorder characterized by involuntary contractions of the facial muscles innervated by the seventh cranial nerve. Generally, it is associated with a poor quality of life due to social embarrassment and can lead to functional blindness. Moreover, it is a chronic condition, and spontaneous recovery is rare. Intramuscular injections of Botulinum Toxin (BoNT) are routinely used as HFS treatment. METHODS We reviewed published articles between 1991 and 2021 regarding the effectiveness and safety of BoNT in HFS as well as any reported differences among BoNT formulations. RESULTS The efficacy of BoNT for HFS treatment ranged from 73% to 98.4%. The mean duration of the effect was around 12 weeks. Effectiveness did not decrease over time. Adverse effects were usually mild and transient. The efficacy and tolerability of the different preparations appeared to be similar. Among the studies, dosage, injected muscles, intervals of treatment, and rating scales were variable, thus leading to challenges in comparing the results. CONCLUSIONS BoNT was the treatment of choice for HFS due to its efficacy and safety profile. Further studies are needed to investigate the factors that influence the outcome, including the optimal timing of treatment, injection techniques, dosage, and the best selection criteria for formulations.
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Affiliation(s)
- Nicola Tambasco
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy;
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
- Correspondence:
| | - Marta Filidei
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
| | - Pasquale Nigro
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy;
| | - Lucilla Parnetti
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
| | - Simone Simoni
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
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El Refaee E, Fleck S, Matthes M, Marx S, Baldauf J, Schroeder HWS. Outcome of Endoscope-Assisted Microvascular Decompression in Patients With Hemifacial Spasm Caused by Severe Indentation of the Brain Stem at the Pontomedullary Sulcus by the Posterior Inferior Cerebellar Artery. Oper Neurosurg (Hagerstown) 2021; 20:E399-E405. [PMID: 33693935 DOI: 10.1093/ons/opab008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Microvascular decompression (MVD) is the most effective treatment option for hemifacial spasm (HFS). However, deeply located forms of compression would require proper identification to allow for adequate decompression. OBJECTIVE To describe the usefulness of endoscopic visualization in one of the most challenging compression patterns in HFS, where the posterior inferior cerebellar artery (PICA) loop is severely indenting the brain stem at the proximal root exit zone of facial nerve along the pontomedullary sulcus. METHODS Radiological and operative data were checked for all patients in whom severe indentation of the brainstem by PICA at pontomedullary sulcus was recorded and endoscope-assisted MVD was performed. Clinical correlation and outcome were analyzed. RESULTS A total of 58 patients with HFS were identified with radiological and surgical evidence proving brainstem indentation at the VII transitional zone. In 31 patients, PICA was the offending vessel to the facial nerve. In 3 patients, the PICA loop was mobilized under visualization of a 45° endoscope. A total of 31 patients had a mean follow-up duration of 52.1 mo. The mean duration between start of complaints and surgery was 7.2 yr. In the last follow-up, all patients had remarkable spasm improvement. A total of 5 patients had more than 90% disappearance of spasms and 26 patients experienced spasm-free outcome. CONCLUSION Although severe indentation of brain stem implies morphological damage, outcome after MVD is excellent. A 45° endoscope is extremely helpful to identify compression down at the pontomedullary sulcus. Deeply located compression site can easily be missed with microscopic inspection alone.
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Affiliation(s)
- Ehab El Refaee
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany.,Department of Neurosurgery, Cairo University, Giza, Egypt
| | - Steffen Fleck
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Marc Matthes
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Sascha Marx
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Joerg Baldauf
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Henry W S Schroeder
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
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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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20
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Yan X, Gu J, Quan J, Zhang X, Zhou X, Qu J, Zhou L. Anatomical deviations of vertebral artery in hemifacial spasm: a quantitative study. Surg Radiol Anat 2020; 43:291-299. [PMID: 33130978 DOI: 10.1007/s00276-020-02603-7] [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: 05/20/2020] [Accepted: 10/15/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE There exist different opinions on whether the anatomical laterality of vertebral artery (VA) is related to the unilateral onset of hemifacial spasm (HFS). In this study, we intended to qualitatively explore the potential correlation between the anatomical deviations of VA and the clinical characteristics of HFS. METHODS Two hundred and forty patients who underwent microvascular decompression for HFS between January 2018 and December 2019 were recruited. Clinical data including medical records and preoperative MRI images were retrospectively reviewed. A score system was specially designed for VAs to illustrate their distribution, and a score-weighted cross-sectional area of VA was proposed to represent the relative thickness of VA on each side. Then, the anatomical deviations of VA were comparatively analyzed between the symptomatic side and asymptomatic side and between VA-involved cases and non-VA-involved cases. RESULTS The score and weighted cross-sectional area (WCSA) of VA in symptomatic side were significantly greater than those in asymptomatic side (P = 0.000, P = 0.000). And in symptomatic side, the score and WCSA of VA in VA-involved cases were significantly greater than those in non-VA-involved cases (P = 0.000). Moreover, with higher score (P = 0.000) and greater WCSA (P = 0.001) on the left side, the VA-involved cases showed a preference (74%) of left HFS. CONCLUSIONS In HFS, the symptomatic side tends to have an ipsilaterally deviated and relatively larger VA, especially in VA-involved cases. And it is the VA-involved cases that are prone to have a prevalence of left HFS, but not the non-VA-involved cases.
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Affiliation(s)
- Xianxia Yan
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China
| | - Junxiang Gu
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China
| | - Junjie Quan
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China
| | - Xi Zhang
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China
| | - Xiaoqian Zhou
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China
| | - Jianqiang Qu
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China
| | - Le Zhou
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, No.157 West Fifth Road, Xi'an, 710004, China.
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Hobson DE, Borys AE. Oculo‐Auricular
Synkinesia Post Bell's Palsy Causing Unilateral Wilson's Phenomenon. Mov Disord Clin Pract 2020; 7:564-566. [DOI: 10.1002/mdc3.12973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/20/2020] [Accepted: 05/03/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Douglas E. Hobson
- Movement Disorder Clinic, Deer Lodge CentreUniversity of Manitoba Winnipeg Manitoba Canada
| | - Andrew E. Borys
- Department of Internal MedicineUniversity of Manitoba Winnipeg Manitoba Canada
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Grippe T, Cunha NSCD, BrandÃo PRDP, Fernandez RNM, Cardoso FEC. How can neurophysiological studies help with movement disorders characterization in clinical practice? A review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:512-522. [PMID: 32901697 DOI: 10.1590/0004-282x20190195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 11/18/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system. OBJECTIVE We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice. METHODS Non-systematic review of the literature published up to June 2019. RESULTS A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus. CONCLUSION These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.
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Affiliation(s)
- Talyta Grippe
- Centro Universitário de Brasília, Faculdade de Medicina, Brasília DF, Brazil.,Hospital de Base do Distrito Federal, Departamento de Neurologia, Brasília DF, Brazil
| | | | | | | | - Francisco Eduardo Costa Cardoso
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
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Yılmaz ATC, Yılmaz M, Öztekin MF. Comparison of preseptal and pretarsal onabotulinum toxin an injection in patients with hemifacial spasm. Int J Neurosci 2020; 131:549-554. [DOI: 10.1080/00207454.2020.1750389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Murat Yılmaz
- Department of Neurology, Abant İzzet Baysal University, Bolu, Turkey
| | - Mehmet Fevzi Öztekin
- Neurology Clinic, Dişkapı Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Sringean J, Dressler D, Bhidayasiri R. More than hemifacial spasm? A case of unilateral facial spasms with systematic review of red flags. J Neurol Sci 2019; 407:116532. [PMID: 31683060 DOI: 10.1016/j.jns.2019.116532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/08/2019] [Accepted: 10/11/2019] [Indexed: 10/25/2022]
Abstract
Unilateral facial spasms (UFS) are frequently caused by hemifacial spasm (HFS), a disorder that usually results from vascular loop compression at the root exit zone of the facial nerve. However, UFS can also be a manifestation of other conditions, including brainstem tumours or demyelination, post-Bell's synkinesis, lesions of the facial nerve in the Faloppio canal and the parotid gland, dystonia, epilepsy, psychogenic conditions, tics and hemimasticatory spasm. In this report, we present a case of UFS, not due to HFS, highlighting clinical red flags for an alternative diagnosis. In addition, a systematic review was conducted to provide a comprehensive summary of UFS differential diagnoses with a list of red flags to assist neurologists in the evaluation of patients with UFS.
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Affiliation(s)
- Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Dirk Dressler
- Movement Disorders Section, Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
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