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At least 883 records · Page 49Linked to original sources
PubMed1988

Surgical treatment of pharyngoesophageal spasm.

The clinical course of 17 laryngectomees with pharyngoesophageal spasm who underwent pharyngeal myotomy was studied to determine clinical response and complications. The influence of speech therapy on the development of volitional control of pharyngoesophageal spasm, tracheoesophageal speech fluency, and the efficacy and complications of surgical treatment for pharyngoesophageal spasm were assessed. Volitional control of tracheoesophageal speech was never achieved. Ninety-four percent of the patients (16/17) were successfully rehabilitated following surgical therapy. The complications following pharyngeal myotomy were acceptable.

Esophageal Spasm, Diffuse↗
PubMed1979

Hypertrophic obstructive cardiomyopathy and coronary artery spasm.

Three patients had hypertrophic obstructive cardiomyopathy and coronary artery spasm. The clinical diagnosis of hypertrophic obstructive cardiomyopathy, in all patients, was confirmed by echocardiography and angiography. Significant spasm of the right coronary artery was demonstrated in each patient by selective coronary arteriography. One patient had atherosclerotic obstructive three vessel disease, while the other two showed no evidence of any fixed organic narrowing of the coronary arteries. ST segment elevation in the inferior ECG leads was documented in two of the patients in association with coronary spasm.

Cardiomegaly↗
PubMed1990

[Hemifacial spasm: results of microvascular decompression in 53 patients].

In a ten year period 53 patients with hemifacial spasm were submitted to 54 microvascular decompression procedures in the posterior fossa. The technique was the same developed by Jannetta and the initial surgical results were considered excellent in 91% of the cases. The follow-up ranges from 60 days to 7 years, with 40 patients followed for more than two years and 16 for more than five years. Only one patient presented late recurrence of the spasms. There was no death nor serious complications which were usually transient and related do the seventh and eight nerve. In four patients we found no compression of the nerve root. We concluded that no matter what the causes of hemifacial spasm or the mechanisms of action of the surgery are the results of microvascular decompression are excellent and superior to all other clinical and surgical methods of treatment.

Adult↗
PubMed2003

[Bilateral hemifacial spasm: case report].

Bilateral hemifacial spasm (BHS) is a rare focal movement disorder often associated with vascular compression of both facial nerves. The contractions are usually asymmetric and asynchronous. Typically, one side is affected first and there is a long but variable interval for the symptoms on the other side to occur. BHS must be differentiated from other conditions including blefarospasm, facial myokymia, facial tics, oromandibular dystonia, and hemimasticatory spasm. The most successful and non-invasive symtomatic treatment is botulinum toxin injections but microvascular decompression surgery is another therapeutic option. We report the case of a 70 years old man with bilateral hemifacial spasms and present a brief review of the literature.

Aged↗
PubMed1991

Hemifacial spasm due to cerebellopontine angle epidermoid tumor--case report.

The authors report a case of cerebellopontine angle epidermoid presenting as typical hemifacial spasm. A 33-year-old male had experienced intermittent right hemifacial spasm for 2 years. Cranial nerve examination was otherwise normal, including auditory and trigeminal nerve functions. Metrizamide computed tomographic cisternography and magnetic resonance imaging demonstrated a characteristic epidermoid tumor. The tumor was totally removed. Postoperatively, no facial spasm or other facial nerve dysfunction was noted.

Adult↗
PubMed2005

Hemifacial spasm following a blow to the mandible causing blunt injury to the peripheral facial nerve.

A 40-year-old male presented with hemifacial spasm manifesting as paroxysmal spontaneous twitches in the left peribuccal region persisting for 3 months. The symptoms began 7 days after an accident, when a signboard hit his left mandibular angle. Physical examination showed no trauma-related change in his face, and no neurological abnormality except for the twitches. Magnetic resonance imaging also showed no abnormalities of the facial nerve and adjacent regions. Electrophysiological studies showed synkinesis, so hemifacial spasm caused by peripheral facial nerve injury was suspect- ed. The symptoms subsided 4 months after the injury. Blunt injury to the facial nerve branches might cause hemifacial spasm.

Adult↗
PubMed2005

Endovascular treatment of vertebral artery aneurysm manifesting as progressive hemifacial spasm.

A 62-year-old woman presented with right hemifacial spasm persisting for 6 months. Brain magnetic resonance imaging and digital subtraction angiography showed a wide-neck aneurysm of the intracranial portion of the right vertebral artery. The patient underwent endovascular trapping of the aneurysm by coil embolization of the parent vessel on both sides of the aneurysm. The patient experienced gradual disappearance of the hemifacial spasm within 3 months. No relapses occurred during a follow-up period of 3 years. Magnetic resonance imaging revealed shrinkage of the vertebral artery aneurysm which had compressed the facial nerve. Endovascular trapping of a vertebral artery aneurysm can be used to treat hemifacial spasm caused by an aneurysm instead of surgical microvascular decompression.

Cerebral Angiography↗
PubMed1993

MR imaging of vascular compression in hemifacial spasm.

Hemifacial spasm is related to vascular compression of the root entry zone of the facial nerve at the brainstem by elongated tortuous vessels of the vertebrobasilar arterial system. In this study, we performed MR imaging in 16 patients with hemifacial spasm and investigated the vascular structures in bilateral-cerebellopontine angles and the relationship of each vessel to the root entry zone of the facial nerve. MR examination was performed with a 0.5 tesla MRI system, and MR angiography (3D time-of-flight) was obtained. Of 15 patients in whom both the nerve and vessels were clearly visible and could be observed to contact each other at the root entry zone, in 11 the tortuous artery could be identified by name. In only 1 patient was the contact between the nerve and vessel indeterminate, due to nonvisualization of the vessel around the facial nerve at its root entry zone. These findings suggest that MRI is a useful screening method in the preoperative assessment of hemifacial spasm.

Adult↗
PubMed1984

Observations on synkinesis in patients with hemifacial spasm. Effect of microvascular decompression and etiological considerations.

In 95 patients with hemifacial spasm, synkinetic actions were measured objectively using electromyographic examination of the blink reflex and impedance audiometry. Abnormal synkinesis between the orbicularis oculi and the orbicularis oris muscles was recorded in 93% of cases, while synkinesis between the stapedius muscle and the facial muscles was recorded in 87%. Neither of these effects could be demonstrated on the unaffected side. The examinations were performed before and after microvascular decompression in 66 cases. Rapid disappearance of synkinesis, often within 10 days, was observed after the relief of vascular compression in 81% of patients who had not undergone previous peripheral facial nerve block procedures. These findings indicate that the synkinesis seen in hemifacial spasm is essentially a reversible condition, and suggest that axonal ephaptic conduction at the vascular compression site plays an important role in the pathophysiological mechanism of hemifacial spasm.

Acoustic Impedance Tests↗
PubMed1991

Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm.

In 11 consecutive patients, intraoperative electromyographic (EMG) recordings were made from the facial muscles during microvascular decompression for hemifacial spasm. In one patient, recordings could not be obtained for technical reasons, and two patients had no abnormality. In the remaining eight patients, the abnormal response resolved before decompression in two, resolved immediately at the time of decompression in five, and failed to resolve in one. All patients were relieved of their hemifacial spasm. In the five patients whose abnormalities resolved at the time of decompression, there was a precise intraoperative correlation between decompression of the nerve and disappearance of the abnormal EMG response. In three cases, this was a useful guide to the need to decompress more than one vessel. These results confirm the findings of Møller and Jannetta, support the use of this technique for intraoperative monitoring of facial nerve decompression procedures, and provide strong circumstantial evidence that vascular cross-compression is an important etiological factor in hemifacial spasm.

Electromyography↗
PubMed1991

Hemifacial spasm caused by a spontaneous dissecting aneurysm of the vertebral artery. Case report.

The authors describe the first reported case of dissecting aneurysm presenting with hemifacial spasm. The patient was a 58-year-old woman with left hemifacial spasm of 2 years' duration. Cranial nerve examination was otherwise normal and no other clinical symptoms were observed. Vertebral angiography revealed a fusiform enlargement of the left vertebral artery and contrast medium remaining in the intramural false lumen in the venous phase. Microvascular decompression of the facial nerve with wrapping of the aneurysm resulted in complete relief of the hemifacial spasm.

Aortic Dissection↗
PubMed1991

Microvascular decompression for hemifacial spasm. Patterns of vascular compression in unsuccessfully operated patients.

To determine the causative factors of unsuccessful microvascular decompression for hemifacial spasm, the follow-up results in 53 patients were assessed retrospectively. The mean follow-up period was 36 months. There were 32 patients who had compression of the seventh cranial nerve ventrocaudally by an anterior inferior cerebellar artery (AICA) or a posterior inferior cerebellar artery. Of these 32 patients, 30 (94%) had excellent postoperative results. Of 14 patients with more severe compression by the vertebral artery, nine (64%) had excellent results, three (21%) had good results, and two (14%) had poor results; in this group, three patients with excellent results experienced transient spasm recurrence. There were seven patients in whom the meatal branch of the AICA coursed between the seventh and eighth cranial nerves and compressed the dorsal aspect of the seventh nerve; this was usually associated with another artery compressing the ventral aspect of the nerve ("sandwich-type" compression). Of these seven patients, five (71%) had poor results including operative failure in one and recurrence of spasm in four. The authors conclude that the clinical outcome was closely related to the patterns of vascular compression.

Adult↗
PubMed2002

Hemilingual spasm: a new neurosurgical entity? Case report.

Hemilingual spasm is a little-known movement disorder, presenting as intermittent paroxysmal involuntary contractions of half of the tongue muscles. The authors report a case of hemilingual spasm caused by an arachnoid cyst. After marsupialization of the cyst, the patient's symptoms immediately resolved. There has been no recurrence of hemilingual spasm during the follow-up period of more than 40 months.

Arachnoid Cysts↗
PubMed1996

Intraoperative monitoring of microvascular decompression in hemifacial spasm.

The significance of intraoperative electrophysiologic monitoring during microvascular decompression was evaluated prospectively in 261 patients with the hemifacial spasm from 1985 to 1995. The patients were divided into a monitored group and a non-monitored group. Identification of the offending vessels was facilitated by the monitoring during the surgical procedure and the complication rate of the monitored group was significantly lower than that of the non-monitored group (p < 0.05). In addition, the abnormal muscle response continued to improve during the follow-up period, thus the electrophysiological status of the hemifacial spasm after the microvascular decompression improved significantly with time (p < 0.05). In conclusion, intraoperative monitoring is useful for identifying the exact offender among multiple vessels, and lowering the complication rate of the microvascular decompression for the hemifacial spasm.

Adult↗
PubMedDate not supplied

Treatment of facial spasm with Oculinum (C. botulinum toxin).

Forty-six consecutive adult patients with facial spasm were treated with one or more Botulinum toxin (Oculinum) injections to control muscle spasm. During the follow-up period of 6.6 months (one week-12 months), 27 patients required retreatment with a mean time interval of 3.4 months between treatments. Control of facial spasm was achieved in all patients. Complications included occasional bruising around the injection site and a transient blepharoptosis in one patient. No systemic effect was observed. This preliminary report suggests that treatment with Botulinum toxin (Oculinum) is an acceptable alternative to surgical management in select patients.

Adult↗
PubMed1991

[A study on auditory disturbances after microvascular decompression for hemifacial spasm].

After establishing an operation of microvascular decompression by Jannetta in 1975, an improvement rate of hemifacial spasm have increased. However, postoperative hearing deficits, equilibrium disturbances and facial paresis have been described in some publications. Fifty-seven of 119 patients with hemifacial spasm operated from 1982 to 1989, were examined by audiometry before and after operation. In patients with tinnitus at the time of facial spasm and closing eyelids, tinnitus improved almost in many cases. Of 57 patients, 8 (5 with sensorineural hearing loss, 3 with conductive hearing loss) had postoperative hearing impairments in operated ears, and 7 (7 with sensorineural hearing loss) had in the other ears, too. Of 7 patients having sensorineural hearing loss observed for several months, 4 having slight sensorineural hearing loss recovered at the same hearing level before operation. In 2 patients having profound sensorineural hearing loss, however, hearing improvement did not observed in each case.

Adult↗
PubMed1998

Vigabatrin: new indication. An advance in infantile spasms.

In children with infantile spasms, vigabatrin monotherapy has been assessed in three published comparative trials. The small numbers of patients make it impossible to draw precise conclusions on effectiveness. However, a few days' treatment with a dose of about 100 mg/kg/day clears infantile spasms in a larger proportion of cases than a placebo or steroids. Vigabatrin seems to be more effective in Bourneville disease. The effect is sometimes transient: despite continued treatment, spasms or other types of epilepsy occur in approximately 50% of patients who are initially improved. In a trial versus ACTH, the lesser initial efficacy of vigabatrin was partly offset by a lower incidence of relapse and other types of seizures. Vigabatrin is effective in some children who are resistant to ACTH or steroids. As with steroids and ACTH, there is no proof that vigabatrin improves the long-term psychomotor development of these children. In comparative trials the incidence of adverse events was statistically lower on vigabatrin than on steroids. Most of the events were relatively mild neuropsychological effects, but a question mark still hangs over the possible neurotoxicity or oculotoxicity of vigabatrin during long-term administration.

Anticonvulsants↗
PubMedDate not supplied

[Botulinum toxin therapy for cricopharyngeal spasm].

A 36-year-old woman presented an inability to ingestion and mild hemiparesis with superficial and deep sensory disturbances on the left side for two months after a stroke. Dysphagia was originated from bilateral cricopharyngeal spasm, which was disclosed by videofluorography, manometry at the pharyngo-esophageal segment, and needle electromyography. Although no focal lesion of the brain was detected even with MRI, neurological and electrophysiological findings suggested that the lesion was localized to the lower pontine and mudullary tegmentum on the right side. Two months after the onset, botulinum toxin (10 units) was administered into the bilateral cricopharyngeal muscles, which resulted in restoration of the normal swallowing function in 5 days, and the normal function is lasting 5 years. Botulinum toxin therapy is non-invasive and effective for cricopharyngeal spasm. This non-invasive method will be the first choice for cricopharyngeal spasm replacing surgical intervention.

Adult↗