Skip to main content

Advertisement

SpringerLink
Log in

Does arteriosclerosis contribute to hemifacial spasm?

  • Clinical Article - Functional
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

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.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Shields PT, Larkins MV, Jho HD (1995) Microvascular decompression for hemifacial spasm. J Neurosurg 82:201–210

    Article  PubMed  Google Scholar 

  2. Bureau CCaHPDHS (2011) The National Health and Nutrition Survey in Japan, 2011. In: Ministry of Health LaW, Japan (ed) Japan

  3. Campos-Benitez M, Kaufmann AM (2008) Neurovascular compression findings in hemifacial spasm. J Neurosurg 109:416–420

    Article  PubMed  Google Scholar 

  4. Choi SY, Park HE, Seo H, Kim M, Cho SH, Oh BH (2013) Arterial stiffness using cardio-ankle vascular index reflects cerebral small vessel disease in healthy young and middle aged subjects. J Atheroscler Thromb 20:178–185

    Article  PubMed  Google Scholar 

  5. Cohen-Gadol AA (2011) Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature. Clin Neurol Neurosurg 113:844–853

    Article  PubMed  Google Scholar 

  6. Defazio G, Berardelli A, Abbruzzese G, Coviello V, De Salvia R, Federico F, Marchese R, Vacca L, Assennato G, Livrea P (2000) Primary hemifacial spasm and arterial hypertension: a multicenter case-control study. Neurology 54:1198–1200

    Article  CAS  PubMed  Google Scholar 

  7. Defazio G, Martino D, Aniello MS, Masi G, Logroscino G, Manobianca G, La Stilla M, Livrea P (2003) Influence of age on the association between primary hemifacial spasm and arterial hypertension. J Neurol Neurosurg Psychiatry 74:979–981

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Inzitari D (2003) Leukoaraiosis: an independent risk factor for stroke? Stroke 34:2067–2071

    Article  PubMed  Google Scholar 

  9. Izuhara M, Shioji K, Kadota S, Baba O, Takeuchi Y, Uegaito T, Mutsuo S, Matsuda M (2008) Relationship of cardio-ankle vascular index (CAVI) to carotid and coronary arteriosclerosis. Circ J 72:1762–1767

    Article  CAS  PubMed  Google Scholar 

  10. Jannetta PJ (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia 20:145–154

    CAS  PubMed  Google Scholar 

  11. Jannetta PJ, Resnick DK (1996) Cranial rhizopathies. In: Youmans J (ed) Neurological surgery, vol 5. W.B. Saunders, Philadelphia, pp 3563–3574

    Google Scholar 

  12. Jho HD, Jannetta PJ (1987) Hemifacial spasm in young people treated with microvascular decompression of the facial nerve. Neurosurgery 20:767–770

    Article  CAS  PubMed  Google Scholar 

  13. Kobata H, Kondo A, Iwasaki K, Nishioka T (1998) Combined hyperactive dysfunction syndrome of the cranial nerves: trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: 11-year experience and review. Neurosurgery 43:1351–1361

    CAS  PubMed  Google Scholar 

  14. Kobata H, Kondo A, Kinuta Y, Iwasaki K, Nishioka T, Hasegawa K (1995) Hemifacial spasm in childhood and adolescence. Neurosurgery 36:710–714

    Article  CAS  PubMed  Google Scholar 

  15. Kondo A, Ishikawa J, Konishi T (1981) The pathogenesis of hemifacial spasm: characteristic changes of vasculatures in vertebro-basilar artery system. In: Sammi M, Jannetta P (eds) The cranial nerves. Springer, New York, pp 494–501

    Chapter  Google Scholar 

  16. Kubozono T, Miyata M, Ueyama K, Nagaki A, Hamasaki S, Kusano K, Kubozono O, Tei C (2009) Association between arterial stiffness and estimated glomerular filtration rate in the Japanese general population. J Atheroscler Thromb 16:840–845

    Article  PubMed  Google Scholar 

  17. Kurokawa Y, Maeda Y, Toyooka T, Inaba K (2004) Microvascular decompression for hemifacial spasm caused by the vertebral artery: a simple and effective transposition method using surgical glue. Surg Neurol 61:398–403

    Article  PubMed  Google Scholar 

  18. Kwon HM, Lee YS (2011) Dolichoectasia of the intracranial arteries. Curr Treat Options Cardiovasc Med 13:261–267

    Article  PubMed  Google Scholar 

  19. Levy EI, Resnick DK, Jannetta PJ, Lovely T, Bissonette DJ (1997) Pediatric hemifacial spasm: the efficacy of microvascular decompression. Pediatr Neurosurg 27:238–241

    Article  CAS  PubMed  Google Scholar 

  20. Nakamura K, Tomaru T, Yamamura S, Miyashita Y, Shirai K, Noike H (2008) Cardio-ankle vascular index is a candidate predictor of coronary atherosclerosis. Cir J 72:598–604

    Article  Google Scholar 

  21. O’Rourke MF (2007) Arterial aging: pathophysiological principles. Vasc Med 12:329–341

    Article  PubMed  Google Scholar 

  22. O’Rourke MF, Safar ME (2005) Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 46:200–204

    Article  PubMed  Google Scholar 

  23. Oliveira LD, Cardoso F, Vargas AP (1999) Hemifacial spasm and arterial hypertension. Mov Disord 14:832–835

    Article  CAS  PubMed  Google Scholar 

  24. Park JH, Kwon HM, Lee J, Kim DS, Ovbiagele B (2015) Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities. Eur J Neurol 22(44-52):e42–e43

    Google Scholar 

  25. Park K, Yasuda N, Toyonaga S, Yamada SM, Nakabayashi H, Nakasato M, Nakagomi T, Tsubosaki E, Shimizu K (2007) Significant association between leukoaraiosis and metabolic syndrome in healthy subjects. Neurology 69:974–978

    Article  CAS  PubMed  Google Scholar 

  26. Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, Miyashita Y, Saiki A, Takahashi M, Suzuki K, Takata M (2011) Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb 18:924–938

    Article  PubMed  Google Scholar 

  27. Shirai K, Utino J, Otsuka K, Takata M (2006) A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). J Atheroscler Thromb 13:101–107

    Article  PubMed  Google Scholar 

  28. Suzuki J, Sakakibara R, Tomaru T, Tateno F, Kishi M, Ogawa E, Kurosu T, Shirai K (2013) Stroke and cardio-ankle vascular stiffness index. J Stroke Cerebrovasc Dis 22:171–175

    Article  PubMed  Google Scholar 

  29. Takaki A, Ogawa H, Wakeyama T, Iwami T, Kimura M, Hadano Y, Matsuda S, Miyazaki Y, Matsuda T, Hiratsuka A, Matsuzaki M (2007) Cardio-ankle vascular index is a new noninvasive parameter of arterial stiffness. Circ J 71:1710–1714

    Article  CAS  PubMed  Google Scholar 

  30. Tan EK, Chan LL, Lum SY, Koh P, Han SY, Fook-Chong SM, Lo YL, Pavanni R, Wong MC, Lim SH (2003) Is hypertension associated with hemifacial spasm? Neurology 60:343–344

    Article  CAS  PubMed  Google Scholar 

  31. Tan NC, Chan LL, Tan EK (2002) Hemifacial spasm and involuntary facial movements. QJM 95:493–500

    Article  PubMed  Google Scholar 

  32. Wong TY, Klein R, Sharrett AR, Couper DJ, Klein BE, Liao DP, Hubbard LD, Mosley TH (2002) Cerebral white matter lesions, retinopathy, and incident clinical stroke. JAMA 288:67–74

    Article  PubMed  Google Scholar 

  33. Yambe T, Yoshizawa M, Saijo Y, Yamaguchi T, Shibata M, Konno S, Nitta S, Kuwayama T (2004) Brachio-ankle pulse wave velocity and cardio-ankle vascular index (CAVI). Biomed Pharmacother 58(Suppl 1):S95–S98

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Drs. Mamoru Niitsu and Kaiji Inoue for diagnosis and helpful comments on the MR images of the patients.

For this work, support was received from a Grant-in-Aid for Young Physicians from Saitama Medical University Hospital Grant Number 24-C-1 (Miki Ohta) and the Japan Society for the Promotion of Science KAKENHI Grant Number 23592105 (Masahito Kobayashi).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan

    Miki Ohta, Masahito Kobayashi, Naruhiko Terano, Kenji Wakiya & Takamitsu Fujimaki

  2. Japan Health Promotion Foundation, 1-24–4 Ebisu, Shibuya-ku, Tokyo, Japan

    Kenji Suzuki

Authors
  1. Miki Ohta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masahito Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naruhiko Terano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenji Wakiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takamitsu Fujimaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miki Ohta.

Ethics declarations

Conflict of interest

None.

Additional information

Comment

Hemifacial spasm due to vascular compression of the facial nerve represents an important neurologic issue that can be effectively treated by microvascular decompression. At the time of surgery many surgeons describe thickened arteries, suggestive of atherosclerotic disease, compressing the root exit zone. This description has persisted in the literature for decades with little solid research into this aspect of the disease.

The authors compared the risk factors hypertension, hyperlipidemia, and diabetes mellitus as well as cardio-ankle vascular indices (CAVI), a measure of global atherosclerosis (Izuhara et al. 2008), and cerebral white matter changes, as a measure of local atherosclerosis (Park et al. 2015), in a series of 111 patients with hemifacial spasm who had undergone microvascular decompression, and compared these factors to the healthy population. They found no significant difference in rates of risk factors or degrees of local or global atherosclerosis between the hemifacial spasm population and the healthy population. Arteriosclerosis is often cited as an etiology for hemifacial spasm and this article provides a fresh perspective on this assumption (Jannetta 1977; Kondo et al. 1981). The authors confirm the findings of the cadaver studies performed by Hosemann (1983).

The authors are to be commended on the fine work in evaluating this important issue. While their work does not elucidate a definite pathophysiologic etiology or risk factor for microvascular compression causing hemifacial spasm, it does lay the groundwork for further study. Further investigations of the association between arteriosclerosis and hemifacial spasm in the elderly population and study of embryological contributions to the genesis of hemifacial spasm are warranted.

Ryan Hofler

Christopher M. Loftus

IL, USA

References

Hosemann W (1983) Intimal fibrosis of cerebellar arteries—a contribution to the pathogenesis of neurovascular syndromes. Laryngol Rhinol Otol (Stuttg) 62:522-525

Izuhara M, Shioji K, Kadota S, Baba O, Takeuchi Y, Uegaito T, Mutsuo S, Matsuda M (2008) Relationship of cardio-ankle vascular index (CAVI) to carotid and coronary arteriosclerosis. Circ J 72:1762-1767

Jannetta PJ (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia 20:145-154

Kondo A, Ishikawa J, Konishi T (1981) The pathogeneshis of hemifacial spasm: characteristic changes of vasculatures in vertebro-basilar artery system. In: Sammi M, Jannetta P (eds) The cranial nerves. Springer, New York, pp 494-501

Park JH, Kwon HM, Lee J, Kim DS, Ovbiagele B (2015) Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities. Eur J Neurol 22:44-52, e42-43

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ohta, M., Kobayashi, M., Terano, N. et al. Does arteriosclerosis contribute to hemifacial spasm?. Acta Neurochir 158, 181–188 (2016). https://doi.org/10.1007/s00701-015-2628-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-015-2628-9

Keywords

Search

Navigation