1
|
Ujihara M, Suzuki S, Kobayashi M, Hirata S, Takabatake K, Hatayama T, Fujimaki T. Is Common Trunk Anomaly Frequent in Hemifacial Spasm? Comparison with Normal Subjects Using Magnetic Resonance Imaging. World Neurosurg 2024:S1878-8750(24)00757-5. [PMID: 38734163 DOI: 10.1016/j.wneu.2024.05.004] [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: 02/14/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE Hemifacial spasm (HFS) results from vascular compression at the root exit of the facial nerve. Although the underlying etiology has yet to be identified, it has been suggested that congenital vascular anomalies are involved. We have hypothesized common trunk anomaly of the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) which may play a role in HFS. However, no previous studies have directly compared the incidence of this anomaly between HFS patients and normal subjects. The present study was designed to address this gap in the literature. METHODS This case-control study compared magnetic resonance angiography data from 65 HFS patients and 65 normal subjects. Dominant AICA/PICA is defined as the absence of PICA/AICA, with the remaining AICA/PICA supplying both vascular territories. The term "common trunk" encompasses both dominant AICA and dominant PICA. The frequency of common trunk and dominant AICA/PICA was compared between the 2 groups. RESULTS There were no significant differences in the incidence of a common trunk (68.5% and 64.6%), dominant AICA (30.8% and 32.3%) and dominant PICA (37.7% and 32.3%) between the 2 groups. Additionally, no differences were found in the frequency of atherosclerosis risk factors. CONCLUSIONS There was no apparent association between common trunk anomaly and HFS. It is suspected that some vascular anomalies other than a common trunk are involved in HFS.
Collapse
Affiliation(s)
- Masaki Ujihara
- Department of Neurosurgery, Saitama Medical University, Saitama, Japan.
| | - Shun Suzuki
- Department of Neurosurgery, Saitama Medical University, Saitama, Japan
| | | | - Sachiko Hirata
- Department of Neurosurgery, Saitama Medical University, Saitama, Japan
| | | | - Toru Hatayama
- Department of Neurosurgery, Mito Brain Heart Center, Mito, Japan
| | | |
Collapse
|
2
|
Horibe G, Yamaguchi S, Kouchi A, Ibata S, Yamamoto T. Weekly Acupuncture for a Patient With Hemifacial Spasms: A Case Report. Cureus 2024; 16:e55219. [PMID: 38562271 PMCID: PMC10983055 DOI: 10.7759/cureus.55219] [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] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
The efficacy and optimal frequency of acupuncture for hemifacial spasms (HFSs) in patients unresponsive or averse to standard treatment methods remains unestablished. Here, we administered acupuncture to a patient with HFSs who was dissatisfied with the outcomes of botulinum toxin (BoNT) injections as symptomatic treatment. A man in his 60s, experiencing frequent spasms in his left facial muscles since 2015, had received several BoNT injections without receiving microvascular decompression or medication; however, the treatment results were not satisfactory. In 2020, he visited our clinic for acupuncture. His entire face twitched involuntarily, and the other Babinski sign was observed. The spasm severity was 5 on the numerical rating scale (NRS). Acupuncture was performed on the gallbladder meridian (GB) 2, stomach meridian (ST) 7, and triple energizer meridian(TE) 17 along the facial nerve and GB14, GB1, small intestine meridian (SI) 18, ST4, ST5, and ST9 on the affected (left) side. In the fourth session, 1 Hz electroacupuncture at ST7 and TE17 reduced the NRS score to 1. As his spasms were well managed, we initially continued with biweekly acupuncture sessions. However, by the 10th session, a worsening of symptoms led to a revert to weekly treatment, which maintained a decreased NRS score until the 21st session. Our findings suggest that weekly acupuncture may be a viable treatment modality for patients with HFSs unresponsive or averse to conventional treatments. Future prospective clinical trials are required to verify the efficacy of acupuncture for HFSs.
Collapse
Affiliation(s)
- Go Horibe
- Department of Oriental Medicine, Saitama Medical University, Saitama, JPN
- Department of Oriental Medicine, Saitama Medical University Kawagoe Clinic, Saitama, JPN
| | - Satoru Yamaguchi
- Department of Oriental Medicine, Saitama Medical University, Saitama, JPN
- Department of Oriental Medicine, Saitama Medical University Kawagoe Clinic, Saitama, JPN
| | - Ai Kouchi
- Department of Oriental Medicine, Saitama Medical University, Saitama, JPN
- Department of Oriental Medicine, Saitama Medical University Kawagoe Clinic, Saitama, JPN
| | - Shintaro Ibata
- Department of Oriental Medicine, Saitama Medical University, Saitama, JPN
- Department of Oriental Medicine, Saitama Medical University Kawagoe Clinic, Saitama, JPN
| | | |
Collapse
|
3
|
Cai J, Du L, Chen C, Xu X, Li Y, Yang X, Chen X, Yu J, Zhang X. Status and Influencing Factors of Body Image Disturbance in Patients With Hemifacial Spasm: A Quantitative and Qualitative Study. World Neurosurg 2024; 182:e186-e195. [PMID: 38006931 DOI: 10.1016/j.wneu.2023.11.072] [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: 10/25/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE Patients diagnosed with hemifacial spasm (HFS) often experience significant facial changes that affect their body image and potentially have a negative impact on their physical and psychological well-being. This study therefore seeks to identify the current state of body image of Chinese patients with HFS, analyze the factors that influence it, and further explore their experiences based on their level of body image disturbance (BID) using a mixed methods approach. METHODS A mixed-methods study was conducted between January 2021 and June 2023. Phase I encompassed the completion of questionnaires by 124 participants. Subsequently, in Phase II, in-depth interviews were conducted with 15 individuals selected from Phase I to gain deeper insights into their specific experiences with BID. RESULTS Patients afflicted with HFS achieved Body Image Scale scores 9.00 (0.00, 12.00). Age, anxiety, depression, and fear of negative evaluation were identified as predictors of exacerbated BID (P < 0.05). Qualitative research predominantly centered on 2 primary themes: the experiences and outward manifestations of BID in HFS patients. These individuals expressed dissatisfaction with their appearance, apprehensions about being the focus of attention, and instances of social avoidance. CONCLUSIONS Owing to varying degrees of anxiety, depression, and apprehension about external evaluation, individuals grappling with HFS are susceptible to experiencing BID. Consequently, when devising interventions, it is imperative to conduct a comprehensive assessment of the patient's condition and implement targeted measures aimed at ameliorating body image, ultimately enhancing the overall quality of life for the patient.
Collapse
Affiliation(s)
- Jing Cai
- Department of Nursing, Medical School of Nantong University, Nantong, China; Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Linjing Du
- Department of Nursing, Medical School of Nantong University, Nantong, China; Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Chunxiang Chen
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China; Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiuqun Xu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China; Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Yanqing Li
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Xueni Yang
- Department of Nursing, Medical School of Nantong University, Nantong, China; Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Xing Chen
- Department of Nursing, Medical School of Nantong University, Nantong, China; Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Jiahui Yu
- Department of Nursing, Medical School of Nantong University, Nantong, China; Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiaomei Zhang
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China; Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, China.
| |
Collapse
|
4
|
Finger G, Wu KC, Vignolles-Jeong J, Godil SS, McGahan BG, Kreatsoulas D, Shujaat MT, Prevedello LM, Prevedello DM. A New Finding on Magnetic Resonance Imaging for Diagnosis of Hemifacial Spasm with High Accuracy and Interobserver Correlation. Brain Sci 2023; 13:1434. [PMID: 37891802 PMCID: PMC10605702 DOI: 10.3390/brainsci13101434] [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: 08/30/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Among patients with clinical hemifacial spasm (HFS), imaging exams aim to identify the neurovascular conflict (NVC) location. It has been proven that the identification in the preoperative exam increases the rate of surgical success. Despite the description of specific magnetic resonance image (MRI) acquisitions, the site of neurovascular compression is not always visualized. The authors describe a new MRI finding that helps in the diagnosis of HFS, and evaluate the sensitivity, specificity, and interobserver correlation of the described sign. A cross-sectional study including cases of hemifacial spasm treated surgically from 1 August 2011 to 31 July 2021 was performed. The MRIs of the cases were independently evaluated by two experienced neuroradiologists, who were blinded regarding the side of the symptom. The neuroradiologists were assigned to evaluate the MRIs in two separate moments. Primarily, they evaluated whether there was a neurovascular conflict based on the standard technique. Following this initial analysis, the neuroradiologists received a file with the description of the novel sign, named Prevedello Sign (PS). In a second moment, the same neuroradiologists were asked to identify the presence of the PS and, if it was present, to report on which side. A total of 35 patients were included, mostly females (65.7%) with a mean age of 59.02 (+0.48). Since the 35 cases were independently evaluated by two neuroradiologists, a total of 70 reports were included in the analysis. The PS was present in 66 patients (sensitivity of 94.2%, specificity of 91.4% and positive predictive value of 90.9%). When both analyses were performed in parallel (standard plus PS), the sensitivity increased to 99.2%. Based on the findings of this study, the authors conclude that PS is helpful in determining the neurovascular conflict location in patients with HFS. Its presence, combined with the standard evaluation, increases the sensitivity of the MRI to over 99%, without increasing risks of harm to patients or resulting in additional costs.
Collapse
Affiliation(s)
- Guilherme Finger
- Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (G.F.); (K.C.W.); (D.K.)
| | - Kyle C. Wu
- Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (G.F.); (K.C.W.); (D.K.)
| | - Joshua Vignolles-Jeong
- College of Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA;
| | - Saniya S. Godil
- Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (G.F.); (K.C.W.); (D.K.)
| | - Ben G. McGahan
- Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (G.F.); (K.C.W.); (D.K.)
| | - Daniel Kreatsoulas
- Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (G.F.); (K.C.W.); (D.K.)
| | - Mohammad T. Shujaat
- Department of Radiology, The Ohio State University College of Medicine, Columbus, OH 43210, USA (L.M.P.)
| | - Luciano M. Prevedello
- Department of Radiology, The Ohio State University College of Medicine, Columbus, OH 43210, USA (L.M.P.)
| | - Daniel M. Prevedello
- Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (G.F.); (K.C.W.); (D.K.)
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Higher betweenness and degree centrality in the frontal and cerebellum cortex of Meige's syndrome patients than hemifacial spasm patients. Neuroreport 2023; 34:102-107. [PMID: 36608166 DOI: 10.1097/wnr.0000000000001865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Meige's syndrome and hemifacial spasm (HFS) are two different forms of dystonic movement disorder, but their difference in terms of resting state functional connectivity (rsFC) remains unclear. The present study applied resting state fMRI on the patients and quantified their functional connectivity with graph theoretical measures, including the degree centrality and the betweenness centrality. Fifteen Meige's syndrome patients and 19 HFS patients matched in age and gender were recruited and their MRI data were collected. To analyze the rsFC, we adopted the Anatomical Automatic Labeling (AAL) template, a brain atlas system including 90 regions of interest (ROIs) covering all the brain regions of cerebral cortex. For each participant, the time-course of each ROI was extracted, and the corresponding degree centrality and betweenness centrality of each ROI were computed. These measures were then compared between the Meige's syndrome patients and the HFS patients. Meige's syndrome patients showed higher betweenness centrality and degree centrality of bilateral superior medial frontal cortex, the left cerebellum cortex, etc. than the HFS patients. Our results suggest that the rsFC pattern in Meige's syndrome patients might become more centralized toward the prefrontal and vestibular cerebellar systems, indicating less flexibility in their functional connections. These results preliminarily revealed the characteristic abnormality in the functional connection of Meige's patients and may help to explore better treatment.
Collapse
|
7
|
Reoperation for residual or recurrent hemifacial spasm after microvascular decompression. Acta Neurochir (Wien) 2022; 164:2963-2973. [PMID: 35922722 DOI: 10.1007/s00701-022-05315-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/10/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE Microvascular decompression (MVD) surgery is the only potential curative method for hemifacial spasm (HFS). Little attention is paid to those recurrent/residual HFS cases. We want to study the potential etiology of those recurrent/residual HFS cases and evaluate the value of reoperation. METHODS We retrospectively reviewed reoperation hemifacial spasm patients in our hospital. Intraoperative videos or images were carefully reviewed, and the etiology of recurrent/residual HFS is roughly divided into three categories. Intraoperative findings, surgical outcomes, and complications were carefully studied to assess the value of reoperation for recurrent/residual HFS patients. RESULTS A total of 28 cases were included in our case series. Twenty-three of them are recurrent HFS cases, and 5 of them are residual HFS cases. The mean follow-up duration is 24.96 months. There are seventeen patients with missed culprit vessels or insufficient decompression of root exit zone (REZ), eight patients with Teflon adhesion, and three patients with improper application of decompression materials in our case series. The final reoperation outcome with 17 excellent, seven good, and four fair, respectively. Eight (28.57%) of them experienced long-term complications after reoperation. CONCLUSION Re-operation for recurrent/residual HFS is an effective therapy and can achieve a higher cure rate. However, the complication rate is higher compared to the first MVD surgery. Accurately identifying REZ and proper decompression strategies to deal with the culprit vessels are very important for surgical success. TRIAL REGISTRATION NUMBER UIN: researchregistry7603. Date of registration: Jan. 31st, 2022 "retrospectively registered".
Collapse
|
8
|
New Technology: Compound Abnormal Muscle Response During Microvascular Decompression for Hemifacial Spasm. J Craniofac Surg 2022; 33:e283-e285. [DOI: 10.1097/scs.0000000000008143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
9
|
Li J, Lyu L, Chen C, Yin S, Jiang S, Zhou P. The outcome of microvascular decompression for hemifacial spasm: a systematic review and meta-analysis. Neurosurg Rev 2022; 45:2201-2210. [PMID: 35048261 DOI: 10.1007/s10143-022-01739-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/22/2021] [Accepted: 01/12/2022] [Indexed: 02/05/2023]
Abstract
Microvascular decompression (MVD) is the first choice of surgery for hemifacial spasm (HFS). MVD surgery for vertebral artery (VA)-associated HFS is more difficult than for non-VA-associated HFS. There is controversy about the cure rate and complication of MVD for HFS in previous studies. We searched PubMed, Web of Science, and Embase for relevant publications. Based on the search results, we compared the outcomes of MVD for VA-associated HFS and non-VA-associated HFS. At the same time, we analyzed spasm-free rates and the complications and assessed the relationship between VA-associated HFS and gender, left side, and age. For analysis, six studies that included 2952 patients in the VA-associated group and 604 in the non-VA-associated group were selected. The effective rate of MVD was not significantly different between both groups (OR = 1.16, 95% CI 0.81-1.67, P = 0.42). Compared to non-VA-associated group, the transient complications (OR = 0.64, 95% CI 0.46-0.89, P = 0.008) and permanent complications (OR = 0.28, 95% CI 0.15-0.54, P = 0.0001) occurred more frequently in VA-associated group. The rate of hearing loss was significantly higher in VA-associated HFS than non-VA-associated HFS (OR = 0.35, 95% CI 0.19-0.64, P = 0.0007); the facial paralysis after operation was not significantly different between both groups (OR = 1.25, 95% CI 0.91-1.72, P = 0.17). There were older patients (WMD = 3.67, 95% CI 3.29-4.05, P < 0.00001) and more left-sided HFS (OR = 0.23, 95% CI 0.19 - 0.29, P < 0.0002) in the VA-associated HFS group than non-VA-associated HFS group, while the non-VA-associated HFS group was female-dominated (OR = 1.58, 95% CI 1.32 - 1.89, P < 0.00001). Both groups achieved good results in MVD cure rates. In VA-associated HFS, the complication rate of decompression and the rate of hearing loss after operation were higher than in non-VA-associated HFS, but the facial paralysis after operation was similar in both groups, and most complications were transient and disappeared during follow-up. VA-associated HFS is more prevalent in older adults, less prevalent in women, and more predominantly left-sided. More clinical studies are needed to better compare the efficacy and complication of MVD between both groups.
Collapse
Affiliation(s)
- Jianguo Li
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China
| | - Liang Lyu
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China
| | - Cheng Chen
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China
| | - Senlin Yin
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China
| | - Shu Jiang
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China
| | - Peizhi Zhou
- Department of Neurosurgery, Pituitary Adenoma Multidisciplinary Center, West China Hospital of Sichuan University, Guoxue Alley, No. 37, Chengdu, 610041, China.
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Su Z, Liang B, Shi F, Gelfond J, Šegalo S, Wang J, Jia P, Hao X. Deep learning-based facial image analysis in medical research: a systematic review protocol. BMJ Open 2021; 11:e047549. [PMID: 34764164 PMCID: PMC8587597 DOI: 10.1136/bmjopen-2020-047549] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Deep learning techniques are gaining momentum in medical research. Evidence shows that deep learning has advantages over humans in image identification and classification, such as facial image analysis in detecting people's medical conditions. While positive findings are available, little is known about the state-of-the-art of deep learning-based facial image analysis in the medical context. For the consideration of patients' welfare and the development of the practice, a timely understanding of the challenges and opportunities faced by research on deep-learning-based facial image analysis is needed. To address this gap, we aim to conduct a systematic review to identify the characteristics and effects of deep learning-based facial image analysis in medical research. Insights gained from this systematic review will provide a much-needed understanding of the characteristics, challenges, as well as opportunities in deep learning-based facial image analysis applied in the contexts of disease detection, diagnosis and prognosis. METHODS Databases including PubMed, PsycINFO, CINAHL, IEEEXplore and Scopus will be searched for relevant studies published in English in September, 2021. Titles, abstracts and full-text articles will be screened to identify eligible articles. A manual search of the reference lists of the included articles will also be conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework was adopted to guide the systematic review process. Two reviewers will independently examine the citations and select studies for inclusion. Discrepancies will be resolved by group discussions till a consensus is reached. Data will be extracted based on the research objective and selection criteria adopted in this study. ETHICS AND DISSEMINATION As the study is a protocol for a systematic review, ethical approval is not required. The study findings will be disseminated via peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42020196473.
Collapse
Affiliation(s)
- Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Bin Liang
- Department of Radiation Oncology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Shi
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd, Shanghai, China
| | - J Gelfond
- Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, UK
| | - Sabina Šegalo
- Department of Microbiology, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Jing Wang
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, University of Twente, Enschede, Netherlands
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), Enschede, UK
| | - Xiaoning Hao
- Division of Health Security Research, National Health Commission of the People's Republic of China, Beijing, Beijing, China
| |
Collapse
|
12
|
Ng JH, Lim EC, Tan EK. Relevance of Prospect Theory to Clinical Care-Seeking Behavior During the COVID-19 Pandemic in Patients With Movement Disorders. Psychosom Med 2021; 83:1091-1092. [PMID: 34747585 DOI: 10.1097/psy.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Jariyakosol S, Uthaithammarat L, Chatwichaikul N, Kasetsuwan N, Chongpison Y. Dry Eye Disease in Hemifacial Spasm Patients Treated with Botulinum Toxin Type A. Clin Ophthalmol 2021; 15:1775-1782. [PMID: 33953536 PMCID: PMC8090983 DOI: 10.2147/opth.s305817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the impact of botulinum toxin type A (BTX-A) on signs and symptoms of dry eye (DE) in affected eye of hemifacial spasm (HFS) patients and to compare the prevalence of DE between affected and non-affected eye in HFS patients. Patients and Methods This prospective study included participants with unilateral HFS, who received BTX-A injection as a treatment. The eyes ipsilateral to the spasm side were used as studied eyes and the contralateral eyes were used as controls. The Ocular Surface Disease Index (OSDI) score, tear break-up time (TBUT), corneal fluorescein staining, and Schirmer I test were measured at baseline, 1 and 3 months after BTX-A injection. Fluorescein clearance test (FCT) was evaluated at baseline and at 1 month after BTX-A injection. Results Thirty-one participants (6 males and 25 females; mean age 61±10 years) were included. The prevalence of DE according to the Asia Dry Eye Society was not significantly different between affected (37.93%) and non-affected eyes (27.6%); P=0.083. At baseline, there was no significant difference in TBUT, Schirmer test, basal tear secretion, presence of delayed tear clearance, and presence of reflex tear secretion between affected and non-affected eyes, while significant difference in Oxford scheme grade was observed (P=0.031). OSDI score, TBUT, Oxford scheme grade, and Schirmer test at 1 month (P=0.817, 0.796, 0.534, 0.556), and 3 months (P=0.803, 0.904, 0.936, 0.684) after BTX-A injection did not significantly change from baseline in affected eyes. FCT results were not significantly different between baseline and at 1-month follow-up in both groups. All findings were corresponding in both naïve and long-term botulinum toxin injection groups. Conclusion We found no significant effect of BTX-A on signs and symptoms of DE in patients with HFS. Moreover, there was no significant association between HFS and DE. However, we found significant corneal surface damage in the affected eyes, which emphasized importance of ocular surface evaluation and prompt treatment in HFS patients.
Collapse
Affiliation(s)
- Supharat Jariyakosol
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Lita Uthaithammarat
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Nattakarn Chatwichaikul
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Ngamjit Kasetsuwan
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Ophthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Center of Excellence for Cornea and Stem Cell Transplantation, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yuda Chongpison
- Biostatistic Excellence Center, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
15
|
Huang B, Yao M, Chen Q, Lin H, Du X, Huang H, Zhao X, Do H, Qian X. Awake CT-guided percutaneous stylomastoid foramen puncture and radiofrequency ablation of facial nerve for treatment of hemifacial spasm. J Neurosurg 2021; 135:1459-1465. [PMID: 33862595 DOI: 10.3171/2020.10.jns203209] [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: 08/20/2020] [Accepted: 10/07/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Hemifacial spasm (HFS) is a debilitating neuromuscular disorder with limited treatment options. The current study describes a novel minimally invasive procedure that provided effective and sustained relief for patients with HFS. The authors provide a detailed description of the awake CT-guided percutaneous radiofrequency ablation (RFA) of the facial nerve for treatment of HFS, and they examine its clinical efficacy. This is the first time in the literature that this procedure has been applied and systematically analyzed for HFS. METHODS Patients with a history of HFS were recruited between August 2018 and April 2020. Those with a history of cerebellopontine lesions, coagulopathy, ongoing pregnancy, cardiac pacemaker or defibrillator implants, or who declined the procedure were excluded from the study. Fifty-three patients who met the study criteria were included and underwent awake CT-guided RFA. Under minimal sedation, a radiofrequency (RF) needle was used to reach the stylomastoid foramen on the affected side under CT guidance, and the facial nerve was localized using a low-frequency stimulation current. Patients were instructed to engage facial muscles as a proxy for motor monitoring during RFA. Ablation stopped when the patients' hemifacial contracture resolved. Patients were kept for inpatient monitoring for 24 hours postoperatively and were followed up monthly to monitor resolution of HFS and complications for up to 19 months. RESULTS The average duration of the procedure was 32-34 minutes. Postoperatively, 91% of the patients (48/53) had complete resolution of HFS, whereas the remaining individuals had partial resolution. A total of 48 patients reported mild to moderate facial paralysis immediately post-RFA, but most resolved within 1 month. No other significant complication was observed during the study period. By the end of the study period, 5 patients had recurrence of mild HFS symptoms, whereas only 2 patients reported dissatisfaction with the treatment results. CONCLUSIONS The authors report for the first time that awake CT-guided RFA of the facial nerve at the stylomastoid foramen is a minimally invasive procedure and can be an effective treatment option for HFS.
Collapse
Affiliation(s)
- Bing Huang
- 1Department of Pain Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing City, Zhejiang, People's Republic of China
| | - Ming Yao
- 1Department of Pain Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing City, Zhejiang, People's Republic of China
| | - QiLiang Chen
- 2Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California
| | - Huidan Lin
- 3Department of Pain Medicine, The First Hospital of Ninbo, Zhejiang
| | - Xindan Du
- 4Department of Pain Medicine, Hangzhou Red Cross Hospital, Hangzhou
| | - Hao Huang
- 5Department of Pain Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou
| | - Xian Zhao
- 6Department of Pain Medicine, Shulan Hospital, Hangzhou, People's Republic of China; and
| | - Huy Do
- 7Department of Interventional Neuroradiology, Stanford University, Palo Alto, California
| | - Xiang Qian
- 2Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California
| |
Collapse
|
16
|
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.
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Han S, Li Y, Li Z, Wang X, Gao J. Two-dimensional structure analysis of hemifacial spasms and surgical outcomes of microvascular decompression. Neurol Res 2020; 43:173-180. [PMID: 33043847 DOI: 10.1080/01616412.2020.1833158] [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: 10/23/2022]
Abstract
BACKGROUND Although studies have indicated that the small posterior fossa plays a role in hemifacial spasm (HFS), few studies have denoted the correlations between local measurements of the cerebellopontine angle and the incidence of HFS and surgical outcomes. METHODS We retrospectively analyzed the demographic and clinical data of HSF patients who underwent microvascular decompression at our institution. Healthy controls were recruited. The divergent prognosis of HFS was defined as an ordinal variable. A multivariable ordinal regression model was generated to estimate the relationship between the variables and outcomes of HFS. RESULTS Between 2013 and 2018, 180 patients who were enrolled in our study met the inclusion criteria. Compared with the control group (n = 94), HFS patients had a smaller internal acousticmeatus-brainstem distance (P < 0.001) on the unaffected side and a larger facial nerve-brainstem angle (P < 0.001). The regression analysis demonstrated that subgroups with more severe facial nerve compression (mild vs severe, OR = 0.269, P = 0.018; moderate vs severe, OR = 0.215, P < 0.001) and a thinner brainstem (OR = 2.368, P = 0.014) were more likely to experience better short-term outcomes, while subgroups with a thinner brainstem (OR = 5.583, P = 0.007) were more likely to experience better long-term outcomes. DISCUSSION Structural changes occurring in patients are risk factors for HFS. The patient's local neurovascular structure and brainstem volume are factors that significantly influence short-term and long-term surgical outcomes.
Collapse
Affiliation(s)
- Shiyuan Han
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China
| | - Yongning Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China.,Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China
| | - Zhimin Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China
| | - Xin Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China
| | - Jun Gao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, China
| |
Collapse
|
19
|
Abstract
Hemifacial spasm (HFS), or facial hemispasm, is a paroxysmal hyperkinetic disorder involving muscles innervated by the facial nerve, mainly on the one hand. The development of HFS is based on neurovascular conflict. However, it is impossible to explain the clinical manifestations of HFS only by nerve compression. Both peripheral and central mechanisms are involved in the generation of HFS, with the formation of ephaptic transmission, antidromic excitation, primary or secondary hyper-excitability of the nuclear and supranuclear level of innervation. Two treatment methods are pathogenetically justified: microvascular decompression (MVD) and botulinum toxin (BTX) injections. The effectiveness of MVD is 95.37% with full or partial recovery. The recurrence rate does not exceed 2.4%. Facial nerve paralysis (2.7-22.5%) and hearing loss (1.9-20%) are the most common complications of treatment with the use of the MVD for HFS with partial or complete cure in most cases. Botulinum toxin injection chemo-denervation is a first-line treatment of primary and secondary HFS. HFS is an officially registered indication for the drug dysport (abobotulotoxin) (ABO) in the Russian Federation. Total doses of ABO ranged from 25 to 150 units for one side depending on the severity of the clinical manifestations. Studies demonstrate the statistically significant benefits of HFC treatment with ABO. ABO is generally well-tolerated. Adverse events (up to 3.6%) are transient and include ptosis, lacrimation, blurred vision, double vision, dry eyes and weak facial muscles.
Collapse
Affiliation(s)
- Z A Zalyalova
- Kazan State Medical University, Kazan, Russia.,Republic Consultative and Diagnostic Center of Extrapyramidal Pathology and Botulinum Therapy of the Tatarstan Republic Ministry of Health, Kazan, Russia
| |
Collapse
|
20
|
Jiang C, Liang W, Wang J, Dai Y, Jin W, Sun X, Xu W. Microvascular decompression for hemifacial spasm associated with distinct offending vessels: A retrospective clinical study. Clin Neurol Neurosurg 2020; 194:105876. [PMID: 32413816 DOI: 10.1016/j.clineuro.2020.105876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the surgical effects and complications of microvascular decompression (MVD) for hemifacial spasm (HFS) based on different offending vessels, and report our surgical experience of HFS patients related to vertebral artery. PATIENTS AND METHODS MVDs performed in Nanjing Drum Tower Hospital between January 1, 2014 and December 31, 2017 were retrospectively studied, and 1152 patients with HFS were split into two groups in accordance with the offending vessels. RESULTS 954 patients with HFS caused by small vascular compression were classified as Group A. 849 patients got cured immediately after MVD, while delayed resolution was identified in 101 patients. 4 patients were not relieved and 4 were relapsed during the follow-up period. We observed 76 cases of delayed facial paralysis, 7 cases of hearing loss, 2 hoarseness and 3 cases of CSF leakage after surgery. In Group B, 198 patients displayed HFS associated with the vertebral artery (VA). 144 cases were spasm free after surgery and 51 patients had a delayed resolution. 3 patients were not significantly ameliorated and 2 were relapsed during the follow-up period. The major postoperative complications included facial paralysis in 28 patients, hearing loss in 4 and hoarseness and dysphagia in 3. The two groups showed no operative death. CONCLUSIONS For the patients with HFS related to VA, the delayed cure rate and the incidence of postoperative cranial nerve complications were higher than HFS attributed to small vascular compression. And the two groups were not different in the long-term outcome and the incidence of permanent cranial nerve complications.
Collapse
Affiliation(s)
- Chengrong Jiang
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, China
| | - Weibang Liang
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, China
| | - Jing Wang
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, China
| | - Yuxiang Dai
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, China
| | - Wei Jin
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, China
| | - Xiaoyang Sun
- Department of Neurosurgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, China.
| | - Wu Xu
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, China.
| |
Collapse
|
21
|
Abnormal brain white matter in patients with hemifacial spasm: a diffusion tensor imaging study. Neuroradiology 2019; 62:369-375. [DOI: 10.1007/s00234-019-02318-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/24/2019] [Indexed: 01/01/2023]
|
22
|
Yang H, Zhou J, Zhong D, Yin Z, Xu G, Chen J, Li J, Liang F. Acupuncture therapy for patients with hemifacial spasm: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e18329. [PMID: 31860984 PMCID: PMC6940167 DOI: 10.1097/md.0000000000018329] [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: 11/04/2022] Open
Abstract
BACKGROUND Hemifacial spasm (HFS) brings a lot of trouble to patients' daily life, having a severe influence on the psychological and physical wellbeing of patients. Relevant researches suggested that acupuncture therapy has potential benefits for HFS. However, there is no consistent conclusion. The purpose of our study is to assess whether acupuncture therapy is effective and safe for HFS. METHODS To collect relevant randomized controlled trials (RCTs), the following electronic databases will be searched: Web of Science, the Cochrane Library, EMBASE, MEDLINE, ISI Web of Knowledge, PsycINFO, Allied and Alternative Medieine, Chinese National Knowledge Infrastructure, Wanfang data, and Chinese Scientific Journals Database. We will take the cure rate and the total effective rate as the primary outcomes, and change in intensity after treatment, change in frequency after treatment, the recurrence rate, and adverse events as secondary outcomes. Endnote software 9.1 will be used for study selection, Review Manager software 5.3, and STATA 13.0 software will be used for analysis and synthesis. RESULTS Current relevant studies will be synthesized to assess whether acupuncture therapy is effective and safe for HFS. CONCLUSION Our research will provide evidence of acupuncture therapy for HFS. REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42019142473.
Collapse
Affiliation(s)
- Han Yang
- College of Acupuncture and Moxibustion and Tuina
| | - Jun Zhou
- College of Acupuncture and Moxibustion and Tuina
| | - Dongling Zhong
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zihan Yin
- College of Acupuncture and Moxibustion and Tuina
| | - Guixing Xu
- College of Acupuncture and Moxibustion and Tuina
| | - Jiao Chen
- College of Acupuncture and Moxibustion and Tuina
| | - Juan Li
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | | |
Collapse
|
23
|
Validation of the Hemifacial Spasm Grading Scale: a clinical tool for hemifacial spasm. Neurol Sci 2019; 40:1887-1892. [PMID: 31076941 DOI: 10.1007/s10072-019-03921-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND To create an objective rating tool for hemifacial spasm (HFS) and validate it on a cohort of patients. METHODS A panel of movement disorders specialists elaborated, through the Delphi method, the Hemifacial Spasm Grading Scale (HSGS). The validity of the scale was tested in a longitudinal, prospective observational study, with standardized video recording protocol before and after botulinum neurotoxin (BoNT) treatment. The video recordings obtained from each patient were then independently assessed with HSGS by three blinded raters. The scale was compared to patient-reported HFS-7 scale and to the clinical grading of spasm intensity scale. RESULTS Intra-rater reproducibility ranged between ICC 0.73 (95% CI = 0.54-0.86) and 0.83 (0.68-0.92) and inter-rater reproducibility between 0.62 (95% CI = 0.44-0.77) and 0.82 (0.69-0.90). HSGS scores correlated with clinical grading of spasm intensity scale scores, but not with HFS-7. HSGS confirmed BoNT efficacy, with scores lowering at 1 month from treatment. CONCLUSIONS HSGS represents an objective, quick and reliable scale for the assessment of HFS, and might be useful to monitor BoNT treatment efficacy over time.
Collapse
|
24
|
Sharma PS, Sattur AP, Patil PB, Nandimath KR, Guttal KS, Burde K. Hemifacial spasm secondary to vascular loop compression: a rare case report. Oral Radiol 2018; 34:273-276. [PMID: 30484026 DOI: 10.1007/s11282-017-0296-6] [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: 03/30/2017] [Accepted: 06/04/2017] [Indexed: 11/25/2022]
Abstract
Hemifacial spasm (HFS) is characterised by brief, persistent, involuntary paroxysmal contractions of the facial muscles innervated by the facial nerve. Broadly its aetiology is portrayed as primary and secondary. Primary HFS is a result of vascular compression of the ipsilateral facial nerve at its root exit zone, and secondary HFS can occur after any injury to the facial nerve from the internal auditory canal to the stylomastoid foramen, which may be a result of a cerebellopontine angle tumour, schwannoma, fusiform aneurysm, or demyelinating lesion such as multiple sclerosis. We report a rare case of HFS in a 40-year-old female patient, who presented with a 4-year history of twitching of the left eye and deviation of the mouth towards the left side. An MRI of the brain revealed a vascular anomaly at the root exit zone of the left facial nerve. The present report aims to highlight MRI as a single, non-invasive diagnostic investigation to confirm the diagnosis of HFS.
Collapse
Affiliation(s)
- Pratibha S Sharma
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, 580009, India.
| | - Atul P Sattur
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, 580009, India
| | - Preetam B Patil
- Department of Radiodiagnosis, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, 580009, India
| | - Kirty R Nandimath
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, 580009, India
| | - Kruthika S Guttal
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, 580009, India
| | - Krishna Burde
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, 580009, India
| |
Collapse
|
25
|
Karir A, Geraghty M, Vassilyadi M, Doja A. Hemifacial Spasm in Mucopolysaccharidosis Type VI (Maroteaux-Lamy Syndrome). TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2018; 8:548. [PMID: 29971196 PMCID: PMC6026275 DOI: 10.7916/d8sx7wfq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/07/2018] [Indexed: 12/01/2022]
Abstract
Background Hemifacial spasms are involuntary contractions of the muscles of one side of the face. Case Report Here, we report a 5-year-old female patient with a significant past medical history, including mucopolysaccharidosis type VI, who also presented with hemifacial spasms. Further investigations showed narrowing of skull foramina and hydrocephalus, but no compression of the facial nerve. Carbamazepine was given to the patient, which caused cessation of the spasms. Discussion Currently, there is no literature discussing the relationship between hemifacial spasms and mucopolysaccharidosis type VI; we have proposed that mucopolysaccharide deposits or dural thickening may contribute to nerve irritation.
Collapse
Affiliation(s)
- Aneesh Karir
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - Michael Geraghty
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.,Division of Metabolics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Michael Vassilyadi
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.,Division of Paediatric Neurosurgery, Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Asif Doja
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.,Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| |
Collapse
|
26
|
Lefaucheur JP, Ben Daamer N, Sangla S, Le Guerinel C. Diagnosis of primary hemifacial spasm. Neurochirurgie 2018; 64:82-86. [DOI: 10.1016/j.neuchi.2017.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 11/28/2022]
|
27
|
Cheng J, Lei D, Hui X, Zhang H. Improvement of Quality of Life in Patients with Hemifacial Spasm After Microvascular Decompression: A Prospective Study. World Neurosurg 2017; 107:549-553. [DOI: 10.1016/j.wneu.2017.08.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 11/28/2022]
|
28
|
Surgical Management of Hemifacial Spasm Associated with Chiari I Malformation: Analysis of 28 Cases. World Neurosurg 2017; 107:464-470. [DOI: 10.1016/j.wneu.2017.08.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 11/19/2022]
|
29
|
Thevenot J, Lopez MB, Hadid A. A Survey on Computer Vision for Assistive Medical Diagnosis From Faces. IEEE J Biomed Health Inform 2017; 22:1497-1511. [PMID: 28991753 DOI: 10.1109/jbhi.2017.2754861] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Automatic medical diagnosis is an emerging center of interest in computer vision as it provides unobtrusive objective information on a patient's condition. The face, as a mirror of health status, can reveal symptomatic indications of specific diseases. Thus, the detection of facial abnormalities or atypical features is at upmost importance when it comes to medical diagnostics. This survey aims to give an overview of the recent developments in medical diagnostics from facial images based on computer vision methods. Various approaches have been considered to assess facial symptoms and to eventually provide further help to the practitioners. However, the developed tools are still seldom used in clinical practice, since their reliability is still a concern due to the lack of clinical validation of the methodologies and their inadequate applicability. Nonetheless, efforts are being made to provide robust solutions suitable for healthcare environments, by dealing with practical issues such as real-time assessment or patients positioning. This survey provides an updated collection of the most relevant and innovative solutions in facial images analysis. The findings show that with the help of computer vision methods, over 30 medical conditions can be preliminarily diagnosed from the automatic detection of some of their symptoms. Furthermore, future perspectives, such as the need for interdisciplinary collaboration and collecting publicly available databases, are highlighted.
Collapse
|
30
|
Abstract
OPINION STATEMENT The treatment of both hemifacial spasm (HFS) and blepharospasm (BEB) requires making the appropriate clinical diagnosis. Advance imaging and electrophysiologic studies are useful; however, one's clinical suspicion is paramount. The purpose of this review is to summarize current and emerging therapies for both entities. Botulinum toxin (BTX) remains the first-line therapy to treat both conditions. If chemodenervation has failed, surgery may be considered. Due to the risks associated with surgery, the benefits of this option must be carefully weighed. Better surgical outcomes are possible when procedures are performed at tertiary centers with experienced surgeons and advanced imaging techniques. Microvascular decompression is an efficacious method to treat HFS, and myectomy is an option for medication-refractory BEB; the risks of the latter may outweigh any meaningful clinical benefits. Oral agents only provide short-term relief and can cause several unwanted effects; they are reserved for patients who cannot receive BTX and/or surgery. Transcranial magnetic stimulation has gained some traction in the treatment of BEB and may provide safer non-invasive options for refractory patients in the future.
Collapse
Affiliation(s)
- Kemar E Green
- Departments of Neurology and Ophthalmology, Michigan State University, East Lansing, MI, USA.
| | - David Rastall
- Michigan State University, College of Osteopathic Medicine, East Lansing, MI, USA
| | - Eric Eggenberger
- Departments of Ophthalmology and Neurology, Mayo Clinic Florida, Jacksonville, FL, USA
| |
Collapse
|
31
|
Idiopathic Synkinesis of the Facial Musculature: Oculo-Nasal, Oculo-Zygomatic, and Fronto-Nasal Synkinesis. J Craniofac Surg 2017; 28:e61-e64. [PMID: 27922972 DOI: 10.1097/scs.0000000000003214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Facial synkinesis is the simultaneous contraction of the certain facial musculature accompanying a motion of designated muscle in the face. With the exception of rare afflictions that are congenital in origin, most patients develop as a sequel to facial nerve paralysis due to trauma, tumor, and surgical injury. As an idiopathic congenital form, oculo-nasal synkinesis which reveals co-contraction of orbicularis oculi and the compressor narium minor muscles which are innervated by separate branches of the facial nerve have been already reported. In addition to oculo-nasal synkinesis, the authors describe 2 more rare patients with facial synkinesis; oculo-zygomatic and fronto-nasal synkinesis with video documentation, which to the best of our knowledge, have not been reported previously in detail. This will help plastic surgeons prevent being involved in legal issues when they might neglect these rare phenomena in preoperative evaluation during cosmetic surgery.
Collapse
|
32
|
Machado RA, Moubayed SP, Khorsandi A, Hernandez-Prera JC, Urken ML. Intermittent facial spasms as the presenting sign of a recurrent pleomorphic adenoma. World J Clin Oncol 2017; 8:86-90. [PMID: 28246588 PMCID: PMC5309717 DOI: 10.5306/wjco.v8.i1.86] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/17/2016] [Accepted: 01/03/2017] [Indexed: 02/06/2023] Open
Abstract
The intimate anatomical relationship of the facial nerve to the parotid parenchyma has a significant influence on the presenting signs and symptoms, diagnosis and treatment of parotid neoplasms. However, to our knowledge, hyperactivity of this nerve, presenting as facial spasm, has never been described as the presenting sign or symptom of a parotid malignancy. We report a case of carcinoma arising in a recurrent pleomorphic adenoma of the left parotid gland (i.e., carcinoma ex pleomorphic adenoma) that presented with hemifacial spasms. We outline the differential diagnosis of hemifacial spasm as well as a proposed pathophysiology. Facial paralysis, lymph node enlargement, skin involvement, and pain have all been associated with parotid malignancies. To date the development of facial spasm has not been reported with parotid malignancies. The most common etiologies for hemifacial spasm are vascular compression of the ipsilateral facial nerve at the cerebellopontine angle (termed primary or idiopathic) (62%), hereditary (2%), secondary to Bell’s palsy or facial nerve injury (17%), and hemifacial spasm mimickers (psychogenic, tics, dystonia, myoclonus, myokymia, myorthythmia, and hemimasticatory spasm) (17%). Hemifacial spasm has not been reported in association with a malignant parotid tumor but must be considered in the differential diagnosis of this presenting symptom.
Collapse
|
33
|
Kongsaengdao S, Maneeton B, Maneeton N. Quality of life in cervical dystonia after treatment with botulinum toxin A: a 24-week prospective study. Neuropsychiatr Dis Treat 2017; 13:127-132. [PMID: 28138245 PMCID: PMC5237598 DOI: 10.2147/ndt.s116325] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This study aimed to identify possible improvements in disease-specific health-related quality of life (HRQoL) after multiple injections of botulinum toxin A over 24 weeks in Thai cervical dystonia (CD) patients. MATERIALS AND METHODS A 24-week prospective study comparing HRQoL of Thai CD patients before and after multiple injections of botulinum toxin A at 3-month intervals was performed. Disease-specific HRQoL was assessed by using the Cervical Dystonia Impact Profile-58 questionnaire (CDIP-58) and the Craniocervical Dystonia Questionnaire-24 (CDQ-24). General HRQoL was assessed by using the Medical Outcomes' 36-Item Short Form Health Survey (SF-36) and the EuroQoL 5-dimension questionnaire (EQ-5D). All the assessments were performed before and after the 24-week treatment period. RESULTS A total of 20 CD patients were enrolled in this study from April to December 2011. CDIP-58 and CDQ-24 scores, which assess disease-specific HRQoL, showed a significant improvement after 24 weeks of treatment by botulinum toxin A (P<0.001). However, EQ-5D and SF-36 scores, which assess general HRQoL, showed no significant improvement after the treatment (P>0.05). CONCLUSION CD patients' disease-specific HRQoL improved after being treated with multiple botulinum toxin A injections. However, general HRQoL was not improved.
Collapse
Affiliation(s)
- Subsai Kongsaengdao
- Division of Neurology, Department of Medicine, Rajvithi Hospital, Department of Medical Services, Public Health Ministry, Bangkok, Thailand; Department of Medicine, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| | - Narong Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| |
Collapse
|
34
|
Dashyian VG, Nikitin AS. Neurovascular conflicts of the posterior cranial fossa. Zh Nevrol Psikhiatr Im S S Korsakova 2017. [DOI: 10.17116/jnevro201711721155-162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
35
|
Jiang C, Xu W, Dai Y, Lu T, Jin W, Liang W. Early permanent disappearance of abnormal muscle response during microvascular decompression for hemifacial spasm: a retrospective clinical study. Neurosurg Rev 2016; 40:479-484. [DOI: 10.1007/s10143-016-0805-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/19/2016] [Accepted: 12/06/2016] [Indexed: 10/20/2022]
|
36
|
Li N, Zhao WG, Pu CH, Yang WL. Hemifacial spasm associated with type 1 Chiari malformation: a retrospective study of 13 cases. Neurosurg Rev 2016; 40:275-279. [PMID: 27422274 DOI: 10.1007/s10143-016-0767-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/11/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022]
Abstract
Hemifacial spasm (HFS) associated with type 1 Chiari malformation is particularly uncommon and is limited to isolated case report. The aims of this study were to report the clinical correlates of patients who had simultaneously HFS and type 1 Chiari malformation and to present the outcome of these patients treated with microvascular decompression (MVD) surgery. We retrospectively evaluated 13 patients who had simultaneously HFS and type 1 Chiari malformation among 675 HFS patients. Clinical features and radiological findings were collected from each patient and analyzed. All these 13 patients were surgically treated with MVD through retro-mastoid microsurgical approach, and postoperative outcomes were evaluated. A review of literature about this association was also provided. In this study, the frequency of type 1 Chiari malformation in HFS patients was 1.9 %. The clinical profile of this series of patients did not differ from typical form of primary HFS. MVD achieved satisfactory results in 11 patients (85 %) in short- and long-term follow-up. There was no mortality or severe complication occurred postoperatively. Although rare, clinician should be aware of the association of HFS and type 1 Chiari malformation and consider MVD as an effective surgical management.
Collapse
Affiliation(s)
- Ning Li
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wei-Guo Zhao
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Chun-Hua Pu
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wen-Lei Yang
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| |
Collapse
|
37
|
Deep NL, Fletcher GP, Nelson KD, Patel AC, Barrs DM, Bendok BR, Hoxworth JM. Magnetic Resonance Imaging Assessment of Vascular Contact of the Facial Nerve in the Asymptomatic Patient. J Neurol Surg B Skull Base 2016; 77:503-509. [PMID: 27857878 DOI: 10.1055/s-0036-1584196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/17/2016] [Indexed: 10/21/2022] Open
Abstract
Objective The objective of this study was to determine the prevalence of facial nerve vascular contact on magnetic resonance imaging (MRI) in patients without hemifacial spasm (HFS). Study Design Our radiology database was queried to identify consecutive adult patients without a history of HFS, intracranial tumor, brain radiation therapy, intracranial surgery, traumatic brain injury, or trigeminal nerve vascular compression. One hundred high-resolution MRIs of the posterior fossa were independently reviewed by two neuroradiologists for facial nerve vascular contact (200 sides). Main Outcome Measures The prevalence of vascular nerve contact in the non-HFS patient, the location of contact along the facial nerve, the culprit vessel, and severity of compression was recorded. Results The presence of vascular contact in the non-HFS patient may be as high as 53%. It is typically mild to moderate in severity, most commonly involves the cisternal portion, and usually caused by the anterior inferior cerebellar artery. Conclusion Vascular contact of the facial nerve is frequently identified in asymptomatic individuals but tends to be more peripheral and mild compared with previous descriptions of neurovascular contact in HFS patients. These results should be considered in assessing the candidacy of HFS patients for microvascular decompression.
Collapse
Affiliation(s)
- Nicholas L Deep
- Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona, United States
| | - Geoffrey P Fletcher
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States
| | - Kent D Nelson
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States
| | - Ameet C Patel
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States
| | - David M Barrs
- Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona, United States
| | - Bernard R Bendok
- Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, United States
| | - Joseph M Hoxworth
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States
| |
Collapse
|
38
|
Vasquez PC, Torres AR, Silvera VM, Scott RM. Hemifacial Spasm in a Child Treated With Microvascular Decompression of the Facial Nerve. Pediatr Neurol 2016; 57:84-7. [PMID: 26880528 DOI: 10.1016/j.pediatrneurol.2016.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/08/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hemifacial spasm is a rare condition in children that is characterized by involuntary contractions of muscles innervated by the ipsilateral facial nerve. PATIENT DESCRIPTION We describe a 6-year-old girl who presented with intermittent involuntary spasms of the right face. Magnetic resonance imaging demostrated a loop of the anterior inferior cerebral artery contacting and elevating the cisternal segment of the right facial nerve; this finding was confirmed at surgery where microvascular decompression of the facial nerve was performed without complication. Following surgery she had immediate remission of symptoms, but the hemifacial spasms slowly recurred within 8 months of surgery only to resolve by age 11 years. CONCLUSION This is the youngest patient reported with hemifacial spasms related to a vascular etiology, which initially responded to surgical treatment. The authors review this syndrome in children and discuss possible etiologies and management options.
Collapse
Affiliation(s)
- Pamela C Vasquez
- Department of Pediatric Neurology, Boston Medical Center, Boston University, Boston, Massachusetts
| | - Alcy R Torres
- Department of Pediatric Neurology, Boston Medical Center, Boston University, Boston, Massachusetts.
| | - V Michelle Silvera
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - R Michael Scott
- Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts
| |
Collapse
|
39
|
Does arteriosclerosis contribute to hemifacial spasm? Acta Neurochir (Wien) 2016; 158:181-7; discussion 188. [PMID: 26545931 DOI: 10.1007/s00701-015-2628-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hemifacial spasm (HFS) is caused by pulsative vascular compression of the root exit zone (REZ) of the facial nerve. However, the mechanism that causes the offending vessels to compress the REZ has not been clarified. Elongation of intracranial arteries due to arteriosclerosis is one possibility, but such arteriosclerotic changes are not observed very frequently among patients with HFS. The aim of the present study was to investigate whether arteriosclerotic changes would contribute to the pathogenesis of HFS. METHODS This study included 111 HFS patients, all of whom were Japanese. The prevalence rates of hypertension, hyperlipidemia, and diabetes mellitus were examined as risk factors of atherosclerosis, and the cardio-ankle vascular index (CAVI) was measured as an indicator of arteriosclerotic change. The severity of white matter lesions (WMLs) in HFS patients was measured by magnetic resonance imaging. These data were compared with data from healthy Japanese controls. RESULTS The prevalence rates of the risk factors for atherosclerosis in the HFS patients were not higher than those in the general Japanese population. The CAVI scores for the HFS patients were similar to, or lower than those in the healthy controls for all age groups except 60 to 69-year-old men. The severity of WMLs in the HFS patients was not significantly worse than that in the controls. CONCLUSIONS It is suggested that arteriosclerotic changes are not involved in the pathogenesis of HFS, and that vascular compression syndromes are attributable to anatomical features of the intracranial arteries and facial nerves formed during the prenatal stage.
Collapse
|
40
|
Cheng J, Fang Y, Zhang H, Lei D, Wu W, You C, Mao B, Mao K. Quantitative Study of Posterior Fossa Crowdedness in Hemifacial Spasm. World Neurosurg 2015; 84:920-6. [DOI: 10.1016/j.wneu.2015.04.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
|
41
|
The structure of facial spasms. Clin Neurophysiol 2015; 127:1003-1004. [PMID: 26374957 DOI: 10.1016/j.clinph.2015.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 08/04/2015] [Accepted: 08/05/2015] [Indexed: 11/21/2022]
|
42
|
Jariyakosol S, Hirunwiwatkul P, Lerdlum S, Phumratprapin C. Prevalence and Associated Factors of Neurovascular Contact in Patients With Hemifacial Spasm. Asia Pac J Ophthalmol (Phila) 2015; 4:212-5. [PMID: 26176193 DOI: 10.1097/apo.0000000000000088] [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: 11/26/2022] Open
Abstract
PURPOSE This study aimed to observe the prevalence and associated factors of neurovascular contact hemifacial spasm (HFS). DESIGN This was a cross-sectional analytical study. METHODS Medical records of patients with HFS in a neuro-ophthalmology clinic in Thailand between June 2008 and June 2012 were reviewed. A positive magnetic resonance imaging finding was defined as an adjacent variant vessel that directly compressed or placed pressure on the affected facial nerve. Prevalence and associated factors were analyzed. RESULTS A total of 60 participants were enrolled, composed of 12 male patients and 48 female patients with a median age of 54 years [interquartile range (IQR), 44.0-64.75] and a disease duration ranging from 4 months to 16 years (median, 2 years; IQR, 1.0-6.0). The prevalence of neurovascular contact HFS was 41.7%. Neurovascular contact HFS was more prevalent among women, with an overall ratio of 3.33. In age group analysis, the prevalence was higher among older patients. In univariate analysis, right-sided symptoms and diabetes mellitus were statistically significant in their association with neurovascular contact HFS (P = 0.040 and P = 0.029, respectively). Right-sided symptoms were significant in a multiple logistic regression analysis (P = 0.038), with an odds ratio of 3.30 [95% confidence interval (CI), 1.07-10.15]. Diabetes mellitus was not statistically significant (P = 0.051), with an odds ratio of 9.99 (95% CI 0.99-96.34). CONCLUSIONS The prevalence of neurovascular contact in patients with HFS was 41.7%. Right-sided symptoms were significantly associated with this condition.
Collapse
Affiliation(s)
- Supharat Jariyakosol
- From the Departments of *Ophthalmology, and †Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | | | | |
Collapse
|
43
|
Sorgun MH, Yilmaz R, Akin YA, Mercan FN, Akbostanci MC. Botulinum toxin injections for the treatment of hemifacial spasm over 16 years. J Clin Neurosci 2015; 22:1319-25. [PMID: 26100157 DOI: 10.1016/j.jocn.2015.02.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 02/11/2015] [Accepted: 02/14/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to investigate the efficacy and side effects of botulinum toxin (BTX) in the treatment of hemifacial spasm (HFS). We also focused on the divergence between different injection techniques and commercial forms. We retrospectively evaluated 470 sessions of BTX injections administered to 68 patients with HFS. The initial time of improvement, duration and degree of improvement, and frequency and duration of adverse effects were analysed. Pretarsal and preseptal injections and Botox (Allergan, Irvine, CA, USA) and Dysport (Ipsen Biopharmaceuticals, Paris, France) brands were compared in terms of efficacy and side effects, accompanied by a review of papers which reported BTX treatment of HFS. An average of 34.5 units was used per patient. The first improvement was felt after 8 days and lasted for 14.8 weeks. Patients experienced a 73.7% improvement. In 79.7% of injections, no adverse effect was reported, in 4.9% erythema, ecchymosis, and swelling in the injection area, in 3.6% facial asymmetry, in 3.4% ptosis, in 3.2% diplopia, and in 2.3% difficulty of eye closure was detected. Patients reported 75% improvement on average after 314 sessions of pretarsal injections and 72.7% improvement after 156 sessions of preseptal injections (p=0.001). The efficacy and side effects of Botox and Dysport were similar. BTX is an effective and safe treatment option for HFS. No difference was determined between Botox and Dysport, and pretarsal injection is better than preseptal injection regarding the reported degree of improvement.
Collapse
Affiliation(s)
- Mine Hayriye Sorgun
- Department of Neurology, Ankara University School of Medicine, İbni Sina Hospital, Samanpazarı, Ankara, Turkey.
| | - Rezzak Yilmaz
- Deptartment of Neurodegeneration, Centre for Neurology and Hertie Institute for Clinical Brain Research, Tübingen University School of Medicine, Tübingen, Germany
| | - Yusuf Alper Akin
- Department of Neurology, Ankara University School of Medicine, İbni Sina Hospital, Samanpazarı, Ankara, Turkey
| | - Fatma Nazli Mercan
- Department of Neurology, Ankara University School of Medicine, İbni Sina Hospital, Samanpazarı, Ankara, Turkey
| | - Muhittin Cenk Akbostanci
- Department of Neurology, Ankara University School of Medicine, İbni Sina Hospital, Samanpazarı, Ankara, Turkey
| |
Collapse
|
44
|
Oh CH, Shim YS, Park H, Kim EY. A case of hemifacial spasm caused by an artery passing through the facial nerve. J Korean Neurosurg Soc 2015; 57:221-4. [PMID: 25810866 PMCID: PMC4373055 DOI: 10.3340/jkns.2015.57.3.221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 12/24/2013] [Accepted: 01/04/2014] [Indexed: 12/05/2022] Open
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.
Collapse
Affiliation(s)
- Chang Hyun Oh
- Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea
| | - Yu Shik Shim
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Hyeonseon Park
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Eun-Young Kim
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| |
Collapse
|
45
|
|
46
|
Hughes MA, Branstetter BF, Taylor CT, Fakhran S, Delfyett WT, Frederickson AM, Sekula RF. MRI findings in patients with a history of failed prior microvascular decompression for hemifacial spasm: how to image and where to look. AJNR Am J Neuroradiol 2014; 36:768-73. [PMID: 25430858 DOI: 10.3174/ajnr.a4174] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/30/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A minority of patients who undergo microvascular decompression for hemifacial spasm do not improve after the first operation. We sought to determine the most common locations of unaddressed neurovascular contact in patients with persistent or recurrent hemifacial spasm despite prior microvascular decompression. MATERIALS AND METHODS Eighteen patients with a history of a microvascular decompression presented with persistent hemifacial spasm. All patients underwent thin-section steady-state free precession MR imaging. Fourteen patients underwent repeat microvascular decompression at our institution. Images were evaluated for the following: the presence of persistent vascular compression of the facial nerve, type of culprit vessel (artery or vein), name of the culprit artery, segment of the nerve in contact with the vessel, and location of the point of contact relative to the existing surgical pledget. The imaging findings were compared with the operative findings. RESULTS In 12 of the 18 patients (67%), persistent vascular compression was identified by imaging. In 11 of these 12 patients, the culprit vessel was an artery. Compression of the attached segment (along the ventral surface of the pons) was identified in most patients (58%, 7/12). The point of contact was proximal to the surgical pledget in most patients (83%, 10/12). The imaging interpretation was concordant with the surgical results regarding artery versus vein in 86% of cases and regarding the segment of the nerve contacted in 92%. CONCLUSIONS In patients with persistent hemifacial spasm despite microvascular decompression, the unaddressed vascular compression is typically proximal to the previously placed pledget, usually along the attached segment of the nerve. Re-imaging with high-resolution T2-weighted MR imaging will usually identify the culprit vessel.
Collapse
Affiliation(s)
- M A Hughes
- From the Departments of Radiology (M.A.H., B.F.B., C.T.T., S.F., W.T.D.)
| | - B F Branstetter
- From the Departments of Radiology (M.A.H., B.F.B., C.T.T., S.F., W.T.D.) Otolaryngology (B.F.B.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - C T Taylor
- From the Departments of Radiology (M.A.H., B.F.B., C.T.T., S.F., W.T.D.)
| | - S Fakhran
- From the Departments of Radiology (M.A.H., B.F.B., C.T.T., S.F., W.T.D.)
| | - W T Delfyett
- From the Departments of Radiology (M.A.H., B.F.B., C.T.T., S.F., W.T.D.)
| | | | | |
Collapse
|
47
|
Ferrazzoli D, Balbi P, Caremani L, Sebastianelli L, Zarucchi A, Capobianco M, Bettiga L, Saltuari L, Frazzitta G. A case of ipsilateral chin-eyelid synkinesis after brain trauma without peripheral facial nerve lesion. Clin Neurol Neurosurg 2014; 123:69-71. [PMID: 25012015 DOI: 10.1016/j.clineuro.2014.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/30/2014] [Accepted: 05/03/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy.
| | - Pietro Balbi
- Department of Neurorehabilitation, Scientific Institute of Pavia via Boezio, IRCCS, 'Salvatore Maugeri' Foundation, Pavia, Italy
| | - Luca Caremani
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy
| | - Luca Sebastianelli
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy
| | - Alessio Zarucchi
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy
| | - Marina Capobianco
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy
| | - Lorenza Bettiga
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy
| | | | - Giuseppe Frazzitta
- Department of Neurorehabilitation, "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy; Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy
| |
Collapse
|
48
|
Martinez ARM, Nunes MB, Immich ND, Piovesana L, França Jr M, Campos LS, D?Abreu A. Misdiagnosis of hemifacial spasm is a frequent event in the primary care setting. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:119-22. [DOI: 10.1590/0004-282x20130227] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/31/2013] [Indexed: 11/21/2022]
Abstract
Primary hemifacial spasm (HFS) is characterized by irregular and involuntary contraction of the muscles innervated by the ipsilateral facial nerve. Treatment controls symptoms and improves quality of life (QoL). Objective : Evaluate the initial diagnosis and treatment of HFS prior to referral to a tertiary center. Method : We interviewed through a standard questionnaire 66 patients currently followed in our center. Results : Mean age: 64.19±11.6 years, mean age of symptoms onset: 51.9±12.5 years, male/female ratio of 1:3. None of the patients had a correct diagnosis in their primary care evaluation. Medication was prescribed to 56.8%. Mean time from symptom onset to botulinum toxin treatment: 4.34 ±7.1 years, with a 95% satisfaction. Thirty percent presented social embarrassment due to HFS. Conclusion : Despite its relatively straightforward diagnosis, all patients had an incorrect diagnosis and treatment on their first evaluation. HFS brings social impairment and the delay in adequate treatment negatively impacts QoL.
Collapse
|
49
|
Gellner AK, Fritsch B. [Semiology and propagation of epileptic seizures]. DER NERVENARZT 2013; 84:747-761. [PMID: 23756821 DOI: 10.1007/s00115-013-3817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The evaluation of episodic seizure-like symptoms is a common challenge in the neurologist's daily routine. The clinical signs (semiology) are the most important puzzle pieces to distinguish epileptic seizures from other episodic entities. Due to the often far-reaching health and social consequences of the diagnosis of epilepsy, the early and rigorous assessment of episodic symptoms by means of the patient history is important. This assessment is based on knowledge of the association of certain semiologies with epileptic syndromes and brain regions; however, certain limitations and pitfalls have to be considered. Typical propagation pathways of seizure activity determine the serial occurrence of semiological features and provide supplementary information.
Collapse
Affiliation(s)
- A-K Gellner
- Neurologische Universitätsklinik, Breisacher Str. 64, 79106 Freiburg, Deutschland
| | | |
Collapse
|
50
|
Peeraully T, Tan SF, Fook-Chong SMC, Prakash KM, Tan EK. Headache in hemifacial spasm patients. Acta Neurol Scand 2013; 127:e24-7. [PMID: 23311349 DOI: 10.1111/ane.12074] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2012] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To assess prevalence of headaches in patients with hemifacial spasm. To determine whether hemifacial spasm provokes headaches and identifies predictive factors. To evaluate whether botulinum toxin given for hemifacial spasm improves headaches. METHODS Seventy patients with hemifacial spasm were evaluated for headaches. The relationship of headaches with hemifacial spasm, impact on quality of life (HIT-6), and improvement in headaches from botulinum toxin was recorded. Data on duration, severity, and impact on quality of life (HFS-7) of hemifacial spasm were collected. RESULTS Hemifacial spasm-related headache was significantly associated with increased hemifacial spasm severity (P < 0.001) and HIT-6 (P = 0.024). Greater hemifacial spasm severity was predictive of hemifacial spasm-related headache (P = 0.006, OR 19.1, 95% CI 2.35-155.64). Botulinum toxin (BTX) for hemifacial spasm improved hemifacial spasm-related headaches (P < 0.001). CONCLUSIONS Hemifacial spasm can complicate headaches, particularly in patients with greater hemifacial spasm severity. Individually tailored regimens of botulinum toxin may be indicated in these patients.
Collapse
Affiliation(s)
- T. Peeraully
- Department of Neurology; Singapore General Hospital; Singapore; Singapore
| | - S.-F. Tan
- Department of Neurology; Singapore General Hospital; Singapore; Singapore
| | | | | | | |
Collapse
|