• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.4
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• pp.163-171
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• 2022

Objectives : The aim of this study was to report that effect of Korean medicine treatment for patient with peripheral facial nerve palsy accompanied by hemifacial spasm through hospitalization. Methods : We treated a patient with facial nerve palsy by acupuncture, electroacupuncture, herbal medicine, pharmacopuncture and cupping. The effect of treatment was evaluated using the House-Brackmann scale, the Yanagihara grading system, and the visual analogue scale(VAS). Results : During the 18 days hospitalization period, the symptoms of hemifacial spasm disappeared and the facial palsy improved. The House-Brackmann scale changed from 4 grade to 2 grade, the Yanagihara grading system changed from 19 to 47, and the VAS changed from 3 to 0. Conclusions : This case report suggests that Korean medicine could be effective for facial palsy accompanied by hemifacial spasms.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.168-170
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• 2014

Dural arteriovenous fistula (AVF) is very rare, acquired lesion that may present with intracranial hemorrhage or neurological deficits. The etiology is not completely understood but dural AVF often has been associated with thrombosis of the involved dural sinuses. To our knowledge, this is the first well documented intracranial hemorrhage case caused by dural AVF following microvascular decompression for hemifacial spasm. A 49-year-old male patient had left microvascular decompression of anterior inferior cerebellar artery via retrosigmoid suboccipital craniotomy. The patient was in good condition without any residual spasm or surgery-related complications. However, after 10 months, he suffered sudden onset of amnesia and dysarthria. Computed tomography and magnetic resonance imaging revealed the presence of dural AVF around the left transverse-sigmoid sinus. The dural AVF was treated with Onyx$^{(R)}$ (ev3) embolization. At the one-year follow up visit, there were no evidence of recurrence and morbidity related to dural AVF and its treatment. This case confirms that the acquired etiology of dural AVF may be associated with retrosigmoid suboccipital craniotomy for hemifacial spasm, even though it is an extremely consequence of this procedure.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.251-254
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• 1993

Hemifacial spasm is a distressing condition characterized by involuntary, intermittent, unilateral twitching of all or parts of the muscles innervated by the facial nerve. This occurrence is most common in middle-aged women. Because etiology of idiopathic hemifacial spasm has remained undefined, no causative agent nor reliable treatment has been established. This report describes a case of CT guided chemical facial nerve block for the treatment of hemifacial spasm. An injection of small amount(0.1 ml) of alcohol(95%) provided relief of the facial spasms.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.2
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• pp.109-118
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• 2022

Objectives The purpose of this study was to investigate Korean medicine treatment on hemifacial spasm and to suggest future research direction. Methods We used seven electronic databases to find articles on Korean medicine treatment of hemifacial spasm and by analyzing the title, abstract, and main text, articles elucidating on Korean medicine treatment on hemifacial spasms were included. Results A total of 68 articles were searched from seven electronic databases. Excluding duplicate articles and articles that satisfied the exclusion criteria, nine articles were included in this study. Acupuncture was used in nine cases, herbal medicine in five cases, physical therapy in three cases, and cupping therapy in one case. In acupuncture, general acupuncture was used in five cases, pharmacopuncture in three cases, and Meridian tendino-musculature acupuncture and thread-embedding therapy in two cases each. Gamigwibi-tang used in two cases was the most frequently used herbal medicine. In physical therapy, carbone, hot pack, interferential current therapy, and silver spike point were used in two cases each. Conclusions It was confirmed that Korean medicine treatment for hemifacial spasm was attempted in varying methods and nearly all cases included in this study showed improvement. However, because of the low level of evidence due to the nature of these case reports, further studies should be conducted for an objective comparison and analysis on the effect of Korean medicine treatment compared to existing treatments.

• Annals of Clinical Neurophysiology
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• v.11 no.2
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• pp.81-82
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• 2009

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.265-270
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• 2006

Objective : Microvascular decompression[MVD] at root exit zone[REZ] of the facial nerve has been largely popularized and it has become the standard treatment for patients with hemifacial spasm[HFS]. This sturdy is performed to evaluate the efficacy of MVD over the course of time. Methods : From 1994 to 2003, 50 patients with HFS who underwent MVD were followed up for more than 6 months. We retrospectively analyzed results with medical records and telephone researches. Results : The mean age of patients at the time operation was 57.6 years and 84% of the patients were female. The mean duration of follow-up after operation was 3.4 years [range $0.5{\sim}7.8\;years$]. One day after MVD, 54% of patients had complete relief of spasm immediately. Continuous improvements of HFS were observed during the follow-up period and these improvements were statistically significant with time (P< 0.05). Until 6 months after operation, complete relief of spasm was observed in 84% of patients. The delayed relief of spasm was observed in 35.7% of our patients who experienced complete relief. Conclusion : The efficacy of MVD in HFS is improves with time. Continuous follow-up evaluations for the duration of more than at least 6 months after MVD are important for the decision of its clinical results because delayed relief of spasms occurs.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.364-367
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• 2013

Microvascular decompression is a very effective and relatively safe surgical modality in the treatment of hemifacial spasm. But rare debilitating complications have been reported such as cranial nerve dysfunctions. We have experienced a very rare case of unilateral soft palate palsy without the involvement of vocal cord following microvascular decompression. A 33-year-old female presented to our out-patient clinic with a history of left hemifacial spasm for 5 years. On postoperative 5th day, patient started to exhibit hoarsness with swallowing difficulty. Symptoms persisted despite rehabilitation. Various laboratory work up with magnetic resonance image showed no abnormal lesions. Two years after surgery patient showed complete recovery of unitaleral soft palate palsy. Various etiologies of unilateral soft palate palsy are reviewed as the treatment and prognosis differs greatly on the cause. Although rare, it is important to keep in mind that such complication could occur after microvascular decompression.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.3
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• pp.262-268
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• 2016

Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.221-224
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• 2015

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.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.59-61
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• 2012

Although the mechanism of hemifacial spasm (HFS) is not yet well established, vascular compression of the facial nerve root exit zone and hyperexcitability of the facial nucleus have been suggested. We report a case of HFS in the setting of coinciding intracranial hemorrhage (ICH) of the pons and proximal ligation of the contralateral vertebral artery (VA) for the treatment of a fusiform aneurysm of the distal VA and discuss the possible etiologies of HFS in this patient. A 51-year-old male with an ICH of the pons was admitted to our hospital. Neuroimaging studies revealed an incidental fusiform aneurysm of the right VA distal to the origin of the posterior inferior cerebellar artery. Eight months after proximal ligation of the VA the patient presented with intermittent spasm of the left side of his face. Pre- and post-ligation magnetic resonance angiography revealed an enlarged diameter of the VA. The spasm completely disappeared after microvascular decompression.