• Journal of Acupuncture Research
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• v.40 no.3
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• pp.201-213
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• 2023

This study reviewed clinical papers reported on hemifacial spasm (HFS). Six online databases were searched for clinical papers published between January 2000 and December 2022. This study reviewed 14 studies, including 13 case reports and 1 combination of case reports and randomized controlled trials (RCTs). The most frequently used acupoints were ST7 and TE17, and the stomach meridian was the most frequently selected. Herbal medicine, pharmacopuncture, thread embedding acupuncture, cupping, moxibustion, and physical therapy were combined with acupuncture. The most frequently used evaluation method is Scott's scale. Out of 95 cases, 82 reported improved HFS symptoms after treatment. Our findings indicated the effectiveness of Korean Medicine treatment in treating HFS. However, evidence of efficacy and safety remains insufficient. Large-scale and well-designed investigations will be required in the future to corroborate these results. We believe that this paper will serve as the foundation for future RCTs.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.43-48
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• 1994

Twenty seven patients with hemifacial spasm were treated by facial nerve block at the foramen stylomastoideum and O'Brien block from January 1992 to March 1994. There were 16 female and ll male patients, a 1.5:1 ratio respectively. Most patients were 40~60 years old. Among the 27 patients treated by nerve blocks, 26 responded well to the facial nerve block, including two cases of O'Brien block. One patient failed to respond to the facial nerve block. Induced facial palsy disappeared within one or two months within the majority of patients. Among the 26 patients who received nerve block, 6 patients required a second block within 3 to 9 months. After successful nerve block, all patients were free of spasm for 1 to 16 months. Although the follow-up period was short in duration, these results suggest that facial nerve block is a satisfactory and reliable method in the treatment of facial spasm.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.340-345
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• 2009

Objective : We investigated the locations of compressing vessels in hemifacial spasm. To approach compression sites, we described and evaluated the efficacy of the infranuchal infrafloccular (INIF) approach. Methods : A retrospective review of 31 consecutive patients who underwent microvascular decompression (MVD) through INIF with a minimum follow-up of 1 year was performed. Along the intracranial facial nerve, we classified the compression sites into the transitional zone (TRZ), the central nervous system (CNS) segment and the peripheral nervous system (PNS) segment. The INIF approach was used to inspect the CNS segment and the TRZ. Subdural patch graft technique was used in order to achieve watertight dural closure. The cranioplasty was performed using polymethylmethacrylate. The outcome and procedure-related morbidities were evaluated. Results : Twenty-nine patients (93%) showed complete disappearance of spasm. In two patients, the spasm was resolved gradually in 2 and 4 weeks, respectively. Late recurrence was noted in one patient (3%). The TRZ has been identified as the only compression site in 19 cases (61.3%), both the TRZ and CNS segment in 11 (35.5%) and the CNS segment only in 1 (3.2%). There was no patient having a compressing vessel in the PNS segment. Infection as a result of cerebrospinal fluid leak occurred in one patient (3%). Delayed transient facial weakness occurred in one patient. Conclusion : The TRZ and the CNS segment were more vulnerable area to the compression of vessels. We suggest that surgical avenue with the INIF approach provides early identification of this area.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.304-307
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• 2017

A 19-year-old male patient presented with facial hemi-atrophy with unilateral spasms of the masseter and temporalis muscles. Ultrasound therapy and Transcutaneous Electric Nerve Stimulation therapy, known as combination therapy, were given on alternate days for 2 weeks. At the end of 2 weeks of combination therapy the patient reported a drastic reduction in the number of episodes of muscle spasm. The visual analog scale score for tenderness of the masseter and temporalis was also markedly reduced. No one has previously used combination therapy for the treatment of facial hemi-atrophy with hemi-facial spasms. The encouraging results of the combination therapy has prompted us to document this study.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.82-85
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• 1995

Hemifacial spasm is a distressing condition characterized clinically by paroxysmal and an involuntary movement in muscles innervated by the facial nerve on one side of the face. Blockade of the facial nerve can be performed percutaneously, without any serious complications. There are certain clinical problems associated with the conventional procedure, such as severe pain and technical difficulties to find facial nerve. This report describes a fluoroscope guided facial nerve block. This new technique reduced the difficulties in identifying the facial nerve and decreased the suffering associated with the conventional way of facial nerve block.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.1-5
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• 2013

Objective : The purpose of this study was to evaluate the characteristics and surgical outcomes of familial hemifacial spasm (HFS) and to discuss the role of genetic susceptibility. Methods : Between 2001 and 2011, 20 familial HFS patients with ten different pedigrees visited our hospital. The data from comprehensive evaluation of these patients, including clinical, radiological and electrophysiological data and surgical outcomes were reviewed to characterize familial HFS and to compare the characteristics between familial HFS and sporadic HFS. Results : According to the family tree, the inheritance pattern was difficult to define clearly using these data. Radiologic findings suggested that the vertebral artery (VA) was a more frequent offender in familial HFS than in sporadic cases (35.0% vs. 10.0%, p<0.001). Chi-square test showed that there were no correlation between VA tortuosity and underlying morbidity such as diabetes or hypertension (p=0.391). Eighteen out of 19 patients who underwent microvascular decompression showed no residual spasm. Other features of familial HFS overlap with sporadic cases. These findings suggest that certain genetic susceptibilities rather than hypertension or diabetes may influence vascular tortuosity and HFS development. Conclusion : In this study, familial HFS seems not so different from sporadic cases. Authors thought familial HFS could have heterogeneous etiology. Further study of familial HFS including clinical, anatomic, genetic, and molecular information may help identify a gene or trait that can provide insight into the mechanisms of sporadic and familial HFS.

• Journal of Pharmacopuncture
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• v.16 no.3
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• pp.52-57
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• 2013

Objectives: The main purpose of this research is to investigate the effect of treatment with Hominis Placental pharmacopuncture (HPP) for 32 patients with hemifacial spasm. Methods: We treated facial spasm patients with acupuncture and HPP at Sabaek (ST2), Seung-eup (ST1), Gwallyeo (SI18), Chanjuk (BL2), Sajukgong (TE23), Hagwan (ST7), Hyeopgeo (ST6), Jichang (ST4), Wan-gol (SI4) and Yepung (TE17), and we investigated the effect by using Scott's scale. The data were analyzed by using the SPSS/10.0 for windows program with descriptive statistics, the paired t-test, and the Shapiro-Wilk normality test. Results: After treatment, the grade of the spasm's intensity based on Scott's description were decreased significantly. About 72% of the patients felt that the combination treatment had produced excellent results. Conclusion: These data suggested that HPP can be useful for treating facial spasm patients.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.197-202
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• 2013

Objectives : Hemifascial spasm is painless uncommon disorder characterised by involuntary paroxysmal movement of one side of face. In this study, the effect of meridian tendino-musculature acupuncture and pharmacopuncture therapy for two patient with hemifascial spasm were evaluated. Methods : We treated two patients with meridian tendino-musculature acupuncture and placenta pharmacopuncture therapy in sternocleidomastoid muscle. We evaluated the effect by Scott's scale and treatment satisfaction. Results : Before therapy, the grade of spasm intensity classified by Scott's description in two cases were 3. After therapy, the Scott's grade of one case was 0, and another case were 1. Conclusions : Meridian tendino-musculature acupuncture and placenta pharmacopuncture therapy in sternocleidomastoid muscle for hemifascial spasm was effective and will be attemped to the patients with it.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.164-172
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• 2002

The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.372-376
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• 2012

Objective : The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment. Methods : Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD. Results : Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was $40.9{\pm}6.9$ months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05). Conclusion : It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD.