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Unusual causes and presentations of hemifacial spasm

Authors
 In-Bo Han  ;  Jong Hee Chang  ;  Jin Woo Chang  ;  Ryoong Huh  ;  Sang Sup Chung 
Citation
 NEUROSURGERY, Vol.65(1) : 130-137, 2009 
Journal Title
 NEUROSURGERY 
ISSN
 0148-396X 
Issue Date
2009
MeSH
Adolescent ; Adult ; Aged ; Decompression, Surgical/adverse effects ; Decompression, Surgical/methods ; Facial Nerve ; Female ; Hemifacial Spasm/etiology* ; Hemifacial Spasm/surgery ; Humans ; Male ; Middle Aged ; Nerve Compression Syndromes/complications* ; Nerve Compression Syndromes/pathology ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/methods ; Retrospective Studies ; Vascular Diseases/complications* ; Vascular Diseases/surgery ; Young Adult
Keywords
Bilateral ; Dolichoectasia ; Facial nerve ; Hemifacial spasm ; Neurovascular compression ; Tic convulsif
Abstract
OBJECTIVE: To evaluate unusual possible causes and clinical presentations of hemifacial spasm (HFS). METHODS: The authors reviewed 1642 cases of HFS. Assessments were based on clinical features, 3-dimensional time-of-flight magnetic resonance angiography, and surgical findings. Causes other than neurovascular compression at the root exit zone of the facial nerve were investigated and unusual clinical presentations were noted. RESULTS: Nine (0.5%) patients had a secondary causative structural lesion, 7 patients had a tumor, and the remaining 2 had a vascular malformation. Direct compression by dolichoectatic vertebrobasilar artery was noted in 12 (0.7%) patients. In 7 (0.4%) patients, only the distal portion of the facial nerve was compressed, and five (0.3%) had only venous compression. Bilateral HFS and tic convulsif were encountered in 7 (0.4%) and 6 (0.37%) patients, respectively. Fifty-six (3.4%) patients were younger than 30 years old at the time of microvascular decompression. CONCLUSION: HFS can result from tumor, vascular malformation, and dolichoectatic artery. Therefore, appropriate preoperative radiological investigations are crucial to achieve a correct diagnosis. The authors emphasize that distal compression or only venous compression can be responsible for persistent or recurrent symptoms postoperatively. In cases of bilateral HFS, a definite differential diagnosis is necessary for appropriate therapy. MVD is recommended as the treatment of choice in patients younger than 30 years old or patients with painful tic convulsif
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006123-200907000-00025&LSLINK=80&D=ovft
DOI
10.1227/01.NEU.0000348548.62440.42
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105232
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