Skip to main content
SpringerLink
Log in

Pathophysiology of Hemifacial Spasm

  • Conference paper
Book cover The Facial Nerve

Abstract

Hemifacial spasm (HFS) is characterized by attacks of spasm on one side of the face that usually begin as small contractions around the eye and that over several years increase in intensity while progressing down the face as the intensity of the spasm increases [4, 5]. The attacks also occur during sleep and can be precipitated by emotional factors. Between attacks, the facial muscles seem to function normally, except for synkinesis of facial muscles and maybe a slight weakness of facial muscles in individuals who have had HFS for a long time [4, 5]. The incidence of HFS is very low (0.74 per 100 000 in white men in the USA and 0.81 per 100000 in white women) [3]. HFS is believed to be caused by vascular compression of the intracranial portion of the facial nerve at its root exit zone (REZ). Microvascular decompression (MVD) of the facial nerve offers a high rate of success for total cure [16, 17, 19] with little side effects, but there is no known medical treatment effective in curing HFS [34].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Auger RG., (1979) Hemifacial spasm: clinical and electrophysiological observations. Neurology 29: 1261–1272

    PubMed  CAS  Google Scholar 

  2. Auger RG, Piepgras DG, Laws ER Jr, Miller RH., (1981) Microvascular decompression of the facial nerve for hemifacial spasm: clinical and electrophysiologic observations. Neurology 31: 346–350

    PubMed  CAS  Google Scholar 

  3. Auger RG, Whisnant JP., (1990) Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984. Arch Neurol 47: 1233–1234

    Article  PubMed  CAS  Google Scholar 

  4. Digre K, Corbett JJ., (1988) Hemifacial spasm: differential diagnosis, mechanism, and treatment. In: Tolosa E., (ed) Facial dyskinesia. Raven, New York, pp 151–176 (Advances in neurology, vol 39 )

    Google Scholar 

  5. Ehni G, Woltman HW., (1945) Hemifacial spasm. Arch Neurol Psychiatry 53: 205–211

    Google Scholar 

  6. Elmquist D, Toremalm NG, Elmer A, Mercke U., (1982) Hemifacial spasm and electrophysiological findings and the therapeutic effect of facial nerve block ( Special Lambert Symposium ). Muscle Nerve 5: 589–594

    Google Scholar 

  7. Esslen E., (1957) Der Spasmus facialis eine Parabiosserscheinung: elektrophysiologische Untersuchungen zum Entstehungsmechanismus des Facialisspasmus. Dtsch Z Nervenheilkd 176: 149–172

    Article  PubMed  CAS  Google Scholar 

  8. Esteban A, Molina-Negro P., (1986) Primary hemifacial spasm: a neurophysiological study. J Neurol Neurosurg Psychiatry 49: 58–63

    Article  PubMed  CAS  Google Scholar 

  9. Ferguson JH., (1978) Hemifacial spasm and the facial nerve nucleus. Ann Neurol 4: 97–103

    Article  PubMed  CAS  Google Scholar 

  10. Fisch U., (1986) Extracranial surgery for facial hyperkinesis. In: May M., (ed) The facial nerve. Thieme, New York, pp 509–523

    Google Scholar 

  11. Fisch U, Esslen E., (1972) The surgial treatment of facial hyperkinesia. Arch Otolaryngol 95: 400–405

    Article  PubMed  CAS  Google Scholar 

  12. Gardner WJ., (1962) Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19: 947–958

    Article  PubMed  CAS  Google Scholar 

  13. Gardner WJ, Sava GA., (1962) Hemifacial spasm — a reversible pathophysiologic. J Neurosurg 19: 240–247

    Article  Google Scholar 

  14. Goddard GV., (1964) Amygdaloid stimulation and learning in the rat. J Comp Physiol Psychol 58: 23–30

    Article  PubMed  CAS  Google Scholar 

  15. Haines SJ, Torres F., (1991) Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm. J Neurosurg 74: 254–257

    Article  PubMed  CAS  Google Scholar 

  16. Jannetta PJ., (1970) Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2: 217–220

    Google Scholar 

  17. Jannetta PJ., (1981) Hemifacial spasm. In: Samii M, Jannetta PJ., (eds) The cranial nerves. Springer, Berlin Heidelberg New York, pp 484–493

    Google Scholar 

  18. Jannetta PJ., (1984) Hemifacial spasm caused by a venule: case report. Neurosurgery 14: 89–92

    Article  PubMed  CAS  Google Scholar 

  19. Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS., (1977) Etiology and definite microsurgical treatment of hemifacial spasm: operative technique and results in 47 patients. J Neurosurg 47: 321–328

    Article  PubMed  CAS  Google Scholar 

  20. Kim P, Fukushima T., (1984) Observations on synkinesis in patients with hemifacial spasm. J Neurosurg 60: 821–827

    Article  PubMed  CAS  Google Scholar 

  21. Kondo A, Ishikawa J, Yamasaki T, Konishi T., (1980) Microvascular decompression of cranial nerves, particularly of the seventh cranial nerve. Neurol Med Chir (Tokyo) 20: 739–751

    Article  CAS  Google Scholar 

  22. Kraft SP, Lang AE., (1988) Cranial dystonia blepharospasm and hemifacial spasm: clinical features and treatment, including the use of botulinum toxin. Can Med Assoc J 139: 837–846

    CAS  Google Scholar 

  23. Møller AR., (1987) Hemifacial spasm: ephaptic transmission or hyperexcitability of the facial motor nucleus? Exp Neurol 98: 110–119

    Article  PubMed  Google Scholar 

  24. Møller AR., (1991) The cranial nerve vascular compression syndrome. II. A review of pathophysiology. Acta Neurochir (Wien) 113: 24–30

    Article  Google Scholar 

  25. Møller AR., (1991) Interaction between the blink reflex and the abnormal muscle response in patients with hemifacial spasm: results of intraoperative recordings. J Neurol Sci 101: 114–123

    Article  PubMed  Google Scholar 

  26. Møller AR, Jannetta PJ., (1984) On the origin of synkinesis in hemifacial spasm: results of intracranial recordings. J Neurosurg 61: 569–576

    Article  PubMed  Google Scholar 

  27. Møller AR, Jannetta PJ., (1985) Microvascular decompression in hemifacial spasm: intraoperative electrophysiological observations. Neurosurgery 16: 612–618

    Article  PubMed  Google Scholar 

  28. Møller AR, Jannetta PJ., (1985) Hemifacial spasm: results of electrophysiologic recording during microvascular decompression operations. Neurology 35: 969–974

    PubMed  Google Scholar 

  29. Møller AR, Jannetta PJ., (1985) Synkinesis in hemifacial spasm: results of recording intracranially from the facial nerve. Experientia 41: 415–417

    Article  PubMed  Google Scholar 

  30. Møller AR, Jannetta PJ., (1986) Blink reflex in patients with hemifacial spasm: observations during microvascular decompression operations. J Neurol Sci 72: 171–182

    Article  PubMed  Google Scholar 

  31. Møller AR, Jannetta PJ., (1986) Physiological abnormalities in hemifacial spasm studied during microvascular decompression operations. Exp Neurol 93: 584–600

    Article  PubMed  Google Scholar 

  32. Møller AR, Jannetta PJ., (1987) Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm. J Neurosurg 66: 681–685

    Article  PubMed  Google Scholar 

  33. Møller AR, Sen CN., (1990) Recordings from the facial nucleus in the rat: signs of abnormal facial muscle response. Exp Brain Res 91: 18–24

    Google Scholar 

  34. Moses H, Alexander GE., (1982) Carbamazepine for hemifacial spasm. Neurology 32: 286–287

    PubMed  Google Scholar 

  35. Nielsen VK., (1984) Pathophysiological aspects of hemifacial spasm, part I. Evidence of ectopic excitation and ephaptic transmission. Neurology 34: 418–426

    PubMed  CAS  Google Scholar 

  36. Nielsen VK., (1984) Pathophysiological aspects of hemifacial spasm, part II. Lateral spread of the supraorbital nerve reflex. Neurology 34: 427–431

    PubMed  CAS  Google Scholar 

  37. Rasminsky M., (1980) Ephaptic transmission between single nerve fibers in the spinal nerve roots of dystrophic mice. J Physiol (Lond) 305: 151–169

    CAS  Google Scholar 

  38. Roth G, Magistris MR, Pinelli P, Rilliet B., (1990) Cryptogenic hemifacial spasm. A neurophysiological study. Electromyogr Clin Neurophysiol 30: 361–370

    PubMed  CAS  Google Scholar 

  39. Samii M., (1981) Surgical treatment of hemifacial spasm. In: Samii M, Jannetta PJ., (eds) The cranial nerves. Springer, Berlin Heidelberg New York, pp 502–504

    Google Scholar 

  40. Sanders DB., (1989) Ephaptic transmission in hemifacial spasm: a single-fiber EMG study. Muscle Nerve 12: 690–694

    Article  PubMed  CAS  Google Scholar 

  41. Sen CN, Moller AR., (1987) Signs of hemifacial spasm created by chronic periodic stimulation of the facial nerve in the rat. Exp Neurol 98: 336–349

    Article  PubMed  CAS  Google Scholar 

  42. Valls-Sole J, Tolosa ES., (1989) Blink reflex excitability cycle in hemifacial spasm. Neurology 39: 1061–1066

    PubMed  CAS  Google Scholar 

  43. Wall PD., (1977) The presence of ineffective synapses and the circumstances which unmask them. Philos Trans R Soc Lond Biol 278: 361–372

    Article  PubMed  CAS  Google Scholar 

  44. Wartenberg R., (1952) Hemifacial spasm. A clinical and pathophysiological study. University Park Press, New York

    Google Scholar 

  45. Williams HL, Lambert EH, Woltman HW., (1952) The problem of synkinesis and contracture in cases of hemifacial spasm and Bell’s palsy. Ann Otol Rhinol Laryngol 61: 850–870

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213-2582, USA

    A. R. Møller

Authors
  1. A. R. Møller
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universität zu Köln, Joseph-Stelzmann-Str. 9, D-50924, Köln, Germany

    E. R. Stennert

  2. Max-Planck-Institut für Psychiatrie und Neuromorphologie, Am Klopferspitz 18a, D-82152, Martinsried, Germany

    G. W. Kreutzberg

  3. Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Joseph-Stelzmann-Str. 9, D-50924, Köln, Germany

    O. Michel (Ltd. Oberarzt) & M. Jungehülsing (Wiss. Mitarbeiter) (Ltd. Oberarzt) &  (Wiss. Mitarbeiter)

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag

About this paper

Cite this paper

Møller, A.R. (1994). Pathophysiology of Hemifacial Spasm. In: Stennert, E.R., Kreutzberg, G.W., Michel, O., Jungehülsing, M. (eds) The Facial Nerve. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85090-5_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-85090-5_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-57686-0

  • Online ISBN: 978-3-642-85090-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation