12
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

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

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

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

          Related collections

          Most cited references45

          • Record: found
          • Abstract: found
          • Article: not found

          Etiology and definitive microsurgical treatment of hemifacial spasm. Operative techniques and results in 47 patients.

          The clinical and operative findings are reviewed in 47 patients with intractable hemifacial spasm. The syndrome was classical in its features in 45 patients and atypical in two. Mechanical compression distortion of the root exit zone of the facial nerve was noted in all 47 patients. In 46 the abnormality was vascular cross-compression, usually by an arterial loop. In one patient, a small cholesteatoma was discovered and removed. Morbidity and postoperative results are discussed.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Hemifacial spasm: clinical findings and treatment.

            Hemifacial spasm (HFS) is a peripherally induced movement disorder characterized by involuntary, unilateral, intermittent, irregular, tonic or clonic contractions of muscles innervated by the ipsilateral facial nerve. We reviewed the clinical features and response to different treatments in 158 patients (61% women) with HFS evaluated at our Movement Disorders Clinic. The mean age at onset was 48.5+/-14.1 years (range: 15-87) and the mean duration of symptoms was 11.4+/-8.5 (range: 0.5-53) years. The left side was affected in 56% instances; 5 patients had bilateral HFS. The lower lid was the most common site of the initial involvement followed by cheek and perioral region. Involuntary eye closure which interfered with vision and social embarrassment were the most common complaints. HFS was associated with trigeminal neuralgia in 5.1% of the cases and 5.7% had prior history of Bell's palsy. Although vascular abnormalities, facial nerve injury, and intracranial tumor were responsible for symptoms in some patients, most patients had no apparent etiology. Botulinum toxin type A (BTX-A) injections, used in 110 patients, provided marked to moderate improvement in 95% of patients. Seven of the 25 (28%) patients who had microvascular decompression reported permanent complications and the HFS recurred in 5 (20%). Although occasionally troublesome, HFS is generally a benign disorder that can be treated effectively with either BTX-A or microvascular decompression.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Hemifacial spasm and involuntary facial movements.

              Hemifacial spasm (HFS) is characterized by tonic and clonic contractions of the muscles innervated by the ipsilateral facial nerve. It is important to distinguish this from other causes of facial spasms, such as psychogenic facial spasm, facial tic, facial myokymia, blepharospasm, and tardive dyskinesia. Magnetic resonance imaging and angiography studies frequently demonstrate vascular compression of the root exit zone of the facial nerve. Importantly, an underlying space-occupying lesion needs to be excluded in patients with associated atypical features such as facial numbness and weakness. Botulinum toxin injection to the facial muscles is an effective treatment for HFS, with few disabling side-effects.
                Bookmark

                Author and article information

                Journal
                J Korean Neurosurg Soc
                J Korean Neurosurg Soc
                JKNS
                Journal of Korean Neurosurgical Society
                The Korean Neurosurgical Society
                2005-3711
                1598-7876
                March 2015
                20 March 2015
                : 57
                : 3
                : 221-224
                Affiliations
                [1 ]Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.
                [2 ]Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea.
                Author notes
                Address for reprints: Eun-Young Kim, M.D., Ph.D. Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha University, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: +82-32-890-2370, Fax: +82-32-890-2374, nskey@ 123456inha.ac.kr
                Article
                10.3340/jkns.2015.57.3.221
                4373055
                14039a43-e022-4942-934f-1f73f0019edd
                Copyright © 2015 The Korean Neurosurgical Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 August 2013
                : 24 December 2013
                : 04 January 2014
                Categories
                Case Report

                Surgery
                hemifacial spasm,penetrating artery,facial nerve,facial weakness
                Surgery
                hemifacial spasm, penetrating artery, facial nerve, facial weakness

                Comments

                Comment on this article