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      Espasmo hemifacial como presentación clínica de meningiomas intracraneales: Presentación de 3 casos y revisión de la literatura Translated title: Hemifacial spasm as clinical presentation of intracranial meningiomas: Report of three cases and review of the literature

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          Abstract

          El espasmo hemifacial (EH) constituye una entidad clínica caracterizada por contracciones tónico-clónicas de carácter involuntario de la musculatura inervada por el nervio facial. Como forma de presentación de meningiomas intracraneales es excepcional. Presentamos tres casos de pacientes con meningiomas cuya presentación clínica fue en forma de EH, bien de forma aislada o asociado a sintomatología de hipertensión intracraneal o déficit neurológico focal. Se revisa la literatura y se discuten los posibles mecanismos fisiopatológicos que puedan intervenir en esta asociación.

          Translated abstract

          Hemifacial spasm (HFS) is a clinical entity consisting of brief clonic jerking movements of the facial musculature, beginning in the orbicularis oculi with downward spreading to other facial muscles. Apart from vascular loop compression at the root exit zone of the facial nerve, other causes of HFS are rare. It is excepcional as a form of presentation of intracranial meningiomas We report three cases of patients with meningiomas who presented with HFS, either as an isolated sign or associated with symptoms of rise intracranial pressure or focal déficit. We review the literature and discuss the possible physiopathological mechanisms responsible for this association.

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          Most cited references18

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          Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984.

          The incidence of hemifacial spasm in residents of Olmsted County, Minnesota, was studied by reviewing the medical records of patients residing in the community between 1960 and 1984. The average annual incidence rate was 0.74 per 100,000 in men and 0.81 per 100,000 in women, age-adjusted to the 1970 US white population. The average prevalence rate was 7.4 per 100,000 population in men and 14.5 per 100,000 in women. The incidence and prevalence rates were highest in those from 40 to 79 years of age.
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            Hemifacial spasm: a review.

            Hemifacial spasm can be diagnosed by observation and clinical history. It is thought to arise primarily from compression of the facial nerve at the pons, usually by an adjacent artery. Although many approaches to treatment have been tried, the most effective is microvascular decompression of the facial nerve at the pons. That operation has well-recognized risks, including ipsilateral deafness. The latter complication ordinarily can be avoided by the use of intraoperative monitoring of auditory evoked potentials.
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              Hemifacial spasm due to tumor, aneurysm, or arteriovenous malformation.

              The authors report eight cases of so-called symptomatic hemifacial spasm. They had gross pathological lesions such as a tumor (one epidermoid, one neurinoma, and two meningiomas), vascular malformation (one medullary venous malformation and two arteriovenous malformations), and aneurysm. In all four cases with a tumor, no artery compressed the facial nerve at the root exit zone. In three of the four cases, the hemifacial spasm disappeared after removal of the tumor in contact with the facial nerve. Compression or encasement of the facial nerve by the tumor was the pathogenesis of the hemifacial spasm in these three cases. The remaining case with tumor (tentorial meningioma) did not have a mass or vessel that directly compressed the facial nerve at the root exit zone. However, the hemifacial spasm disappeared after the removal of the tumor. In a case with a medullary venous malformation with arterial component, an engorged draining vein compressed the root exit zone of the facial nerve. In the remaining three vascular cases--two cases of arteriovenous malformation and a case of saccular aneurysm--enlarged feeding arteries and an aneurysm directly compressed the root exit zone of the facial nerve. Not only arterial or venous but also mass compression can cause hemifacial spasm in some symptomatic cases. Surgical decompression of the facial nerve from the causative organic lesion is the primary choice of treatment.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                neuro
                Neurocirugía
                Neurocirugía
                Sociedad Española de Neurocirugía (Murcia )
                1130-1473
                February 2005
                : 16
                : 1
                : 21-26
                Affiliations
                [1 ] Hospital Regional Universitario Infanta Cristina
                Article
                S1130-14732005000100003
                10.4321/s1130-14732005000100003
                490d3903-590d-45e5-a1aa-9f60f6de6ad9

                http://creativecommons.org/licenses/by/4.0/

                History
                Categories
                NEUROSCIENCES
                SURGERY

                Surgery,Neurosciences
                Meningioma,Hemifacial spasm,Espasmo hemifacial
                Surgery, Neurosciences
                Meningioma, Hemifacial spasm, Espasmo hemifacial

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