• The Korean Journal of Pain
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• v.10 no.1
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• pp.16-20
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• 1997

Background : Hemifacial spasm commonly occurs on muscles about the eye, but may also involve or spread to the entire side of the face. There are many treatment for facial spasm, such as neuro-vascular decompression, local injection of Botulium toxin, facial nerve block at stylomastoid foramen, facial nerve block with O'Brien method. The present study was aimed to investigate the effects of facial nerve block with O'Brien method. Methods : Forty five patients with hemifacial spasm were treated by facial nerve block with O'Brien method from January 1996 to February 1997 We reviewed the charts, retrospectively. Results : Sex ratio was 1:1.7(17 male : 28 female patients). Most patients were 40~60 years old. Most patients well tolerated facial nerve block. Three patients failed to respond to the facial nerve block. We repeated the procedure within one week. Among the 45 patients who received nerve block, 35 received repeated block; 7 patients received second repeat block, 2 patients received third repeat block. After successful nerve block, all patients were free of spasm for 1 to 6 months. Average spasm-free period was 3.5 months. Conclusion : Although the spasm-free period was short, these results suggest facial nerve block with O'Brien method is a safe and comfortable method for treatment of facial spasm.

• Journal of Korean Neurosurgical Society
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• v.42 no.5
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• pp.355-362
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• 2007

Hemifacial spasm (HFS) is characterized by tonic clonic contractions of the muscles innervated by the ipsilateral facial nerve. Compression of the facial nerve by an ectatic vessel is widely recognized as the most common underlying etiology. HFS needs to be differentiated from other causes of facial spasms, such as facial tic, ocular myokymia, and blepharospasm. To understand the overall craniofacial abnormalities and to perform the optimal surgical procedures for HFS, we are to review the prevalence, pathophysiology, differential diagnosis, details of each treatment modality, usefulness of brainstem auditory evoked potentials monitoring, debates on the facial EMG, clinical course, and complications from the literature published from 1995 to the present time.

• Journal of Korean Neurosurgical Society
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• v.44 no.6
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• pp.399-400
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• 2008

Hemifacial spasm induced by intracranial aneurysm is a rare clinical condition. A 45-year-old male patient presented with a 3-year history of progressive involuntary twitching movement on right face. On radiological study, a dilated vascular lesion compressing the brain stem was found at the junction of vertebral artery and posterior inferior cerebellar artery. On operative field, we found the posterior inferior cerebellar artery and the fusiform aneurysm compressing root exit zone of facial nerve. Microvascular decompression was performed and the facial symptom was relieved without complications.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.117-120
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• 2005

Hemifacial spasm (HFS) may develop after Bell's palsy (BP). But it was not reported that contralateral HFS occurred simultaneously in acute BP. A 25-year-old woman admitted with left HFS occurred simultaneously in acute right BP for 6 days. Past, family, and social history were unremarkable. Nerve conduction studies (NCS) and blink reflex (BR) test showed bilateral facial neuropathies. Brain MRI and cerebral angiography were normal. The symptoms and signs of HFS and BP were improved slowly after acyclovir and prednisolone therapy. Follow-up serial NCS and BR also showed a rapid improvement.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.367-375
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• 2019

Hemifacial spasm (HFS) is due to the vascular compression of the facial nerve at its root exit zone (REZ). Microvascular decompression (MVD) of the facial nerve near the REZ is an effective treatment for HFS. In MVD for HFS, intraoperative neurophysiological monitoring (INM) has two purposes. The first purpose is to prevent injury to neural structures such as the vestibulocochlear nerve and facial nerve during MVD surgery, which is possible through INM of brainstem auditory evoked potential and facial nerve electromyography (EMG). The second purpose is the unique feature of MVD for HFS, which is to assess and optimize the effectiveness of the vascular decompression. The purpose is achieved mainly through monitoring of abnormal facial nerve EMG that is called as lateral spread response (LSR) and is also partially possible through Z-L response, facial F-wave, and facial motor evoked potentials. Based on the information regarding INM mentioned above, MVD for HFS can be considered as a more safe and effective treatment.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.245-248
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• 2008

Objective : This study is to investigate time course of symptom disappearance in patients whose spasm relieved completely after microvascular decompression (MVD). Methods : Of 115 patients with hemifacial spasm (HFS) who underwent MVD from April 2003 to December 2006, 89 patients who had no facial paralysis after operation and showed no spasm at last follow-up more than 1.5 years after operation were selected. Symptom disappearance with time after MVD was classified into type 1 (symptom disappearance right after operation), type 2 (delayed symptom disappearance) and type 3 (unusual symptom disappearance). Type 2 was classified into type 2a (with postoperative silent period) and type 2b (without silent period). Results : Type 1, type 2a, type 2b and type 3 were 38.2%, 48.37%, 124% and 1.1%, respectively. Delayed disappearance group (type 2) was 60.7%. Post-operative symptom duration in all cases ranged from 0 to 900 days, average was 74.6 days and median was 14 days. In case of type 2, average post-operative symptom duration was 115.1 days and median was 42 days. Five and 3 patients required more than 1 year and 2 years, respectively, until complete disappearance of spasm. In type 2a, postoperative silent period ranged from 1 to 10 days, with an average of 24 days. Conclusion : Surgeons should be aware that delayed symptom disappearance after MVD for HFS is more common than it has been reported, silent period can be as long as 10 days and time course of symptom disappearance is various as well as unpredictable.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.89-93
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• 1996

Hemifacial spasm commonly occurs in muscles about the eye, but may also involve or spread to the entire side of the face. One hundred and seventy eight patients with hemifacial spasm visited our Neuro-Pain clinic from January 1992 to April 1996. There were 121 female and 57 male patients, a 2.1:1 ratio respectively. Largest percentages of patients were in the 50 year old range. Among them, 96 patients were treated by facial nerve block or O'Brien block. In most cases, induced facial palsy disappeared within one or two months. Among the 96 patients who received nerve block, 46 patients received a second block within 5 to 24 months. The average interval from first and second nerve block was 11.5 months. After nerve block, all patients were free from spasm for 1 to 21 months. We conclude that facial nerve block is a satisfactory and reliable method for the treatment of facial spasm.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.229-238
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• 2006

Background and Objetive : The aim of this study is to report 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients. It is a rare disease, with few research on the effect of acupuncture therapy on it. Material and Method : We selected 3 cases of facial palsy following microvascular decompression in hemifacial spasm patients, among patients who visited the Facial palsy Clinic of Kyunghee Oriental Medical Center. We treated them with acupuncture therapy(ST6, ST4, BL2, TE17, GV24, GV14, and Ex-HN4 of the healthy side, and LI4 and ST36 of both sides) and aroma therapy. After treatment we observed and checked any changes within clinical symptoms using the House-Brackmann Grade and the Yanagihara's Unweighted Grading System. Result and Conclusion : 1. All three cases were of hemifacial spasm patients who had facial palsy following microvascular decompression. The patients visited 27 months(Case1), 2 months(Case2) and 7 months(Case 3) after the surgery respectively. 2. Period of time till complete recovery is 23 months(Case1), 8 months(Case2) and 3 month (Case3) respectively. 3. All three cases had symptoms of sequelae: retraction of mouth toward the healthy side and involuntary spasm of lips. The later the initiation of treatment after the sugery, the more severe symptoms of sequelae.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.423-425
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• 1996

Tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs predominantly in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery - less frequently an arteriovenous malformation or cholesteatoma - which compresses the trigeminal and facial nerve roots in the postetior fossa. In rare instances this syndrome may be caused by brain tumor. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography should be performed in every case. We experienced a case of trigeminal neuralgia(mandibular division)and contralateral hemifacial spasm.

• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.336-340
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• 2009

Objective : The factors that influence the prognosis of patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD) have not been definitely established. We report a prospective study evaluating the prognostic factors in patients undergoing MVD for HFS. Methods : From January 2004 to September 2006, the authors prospectively studied a series of 293 patients who underwent MVD for HFS. We prospectively analyzed a number of variables in order to evaluate the predictive value of independent variables for the prognosis of patients undergoing MVD. The patients were followed-up at regular intervals and divided into as cured and unsatisfactory groups based on symptom relief. Uni- and multivariate analyses were performed using logistic regression models. Results : A total 273 of 293 (94.2%) patients achieved symptom relief within one year after the operation. Intraoperatively, the indentation of the root exit zone was observed in 259 (88.5%) patients. Uni- and multivariate analyses revealed that the symptoms at postoperative 3 months (p<0.001) and indentation of the root exit zone (p=0.036) were associated with good outcomes. Conclusion : The intraoperative finding of root exit zone indentation will help physicians determine the prognosis in patients with HFS. To predict the prognosis of HFS, a regular follow-up period of at least 3 months following MVD should be required.