• 한방안이비인후피부과학회지
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• 제35권4호
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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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• 제56권2호
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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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• 제6권2호
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• pp.251-254
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• 1993

안면근 경련의 치료로서 물리적 안면신경차단(physical facial nerve block)은 직접적으로 바늘을 사용하여 안면신경을 직접 천자하여 안면근 경련을 치료하는 방법이다. 그러나 이 방법은 기술적으로 어렵고, 안면신경차단의 정도가 안면경련을 해소할 만큼 충분하지 못하기 때문에 부가적으로 소량의 국소마취제나 알코올을 사용한 화학적 안면신경차단이 필요한 경우가 많다. 이러한 화학적 신경차단을 보다 정확하고 부작용없이 시행하기 위하여 CT 유도하에서 본 증례를 시행한 결과 간헐적인 안면근경련의 재발이 있었으나, 통증의 강도가 많이 줄어들었으며, 통증기간도 줄어들었다.

• 척추신경추나의학회지
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• 제17권2호
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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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• 제11권2호
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• pp.81-82
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• 2009

• Journal of Korean Neurosurgical Society
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• 제39권4호
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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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• 제53권6호
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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.

• 대한임상검사과학회지
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• 제48권3호
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• pp.262-268
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• 2016

편측성 안면경련(hemifacial spasm)은 불수의적으로 안면의 근육에서 발작적인 경련이 일측성으로 반복해서 발생하는 질환이다. 한 근육의 수축으로 인해 동시적으로 여러 근육이 동시에 수축되는 동시 수축성(synkinesia)이 특징이다. 발병원인은 제 7뇌신경인 안면신경이 혈관에 의해 압박을 받아서 나타나게 된다. 본 연구는 편측성 안면경련 환자의 미세혈관 감압 수술을 받은 환자를 대상으로 수술 중 진행되는 신경계 감시검사 방법들에 대해 다루었다. 청각유발전위 검사에서는 수술용 뇌 견인기의 사용시 주의 사항과 검사시기에 대해 언급하였다. 안면신경의 근전도검사에서는 잡파의 혼입과 신경손상 시 근전도 파형의 감별에 대해, 측면전파 반응 검사에서는 마취의 유지의 중요성에 대해 그리고 체성감각 유발전위검사에서는 환자를 좀더 자세하게 검사할 수 있도록 새로운 방법을 제안하였다. 위에 언급한 내용들을 토대로 검사한다면 수술 중 신경계 감시 검사를 원활하게 할 수 있으리라 생각된다.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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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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• 제51권1호
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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.