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At least 1,423 records · Page 79Linked to original sources
PubMed1990

[Neurophysiological study on hemifacial spasm--the abnormality and origin of the electromyographic response to stimulation of the facial nerve].

Electromyographic responses (MD-OC) of the orbicularis oculi muscle to stimulation of ipsilateral marginal mandibular branch of the facial nerve were recorded in 20 patients with hemifacial spasm, pre-, post-operatively and during operations to relieve it by microvascular decompression, and the abnormal features and origin of the MD-OC were investigated. On the affected side, the MD-OC were recorded in pre- and during operative state, and disappeared with disappearance of hemifacial spasm after microvascular decompression, while no response was recorded in pre-, during and post-operative state on the healthy side. In 17 patients, the MD-OC was recorded continuously during operation. In all cases except for one case in whom the MD-OC was recorded even the end of operation, the MD-OC disappeared on several stage of procedure from dural opening through vascular mobilization. The compound nerve action potential (MD-VII) to stimulation of the marginal mandibular branch was recorded from the facial nerve near its root entry zone after exposure of the intracranial portion. There were two patterns in the records, i.e., one group consisting of early component and the other consisting of early and late component. The MD-VII was only consisted of the early component in 12 cases in whom the MD-OC have already disappeared, and was consisted of the early and late component in 5 cases in whom the MD-OC still recorded. And in 2 cases of the later, the late component disappeared simultaneously with disappearance of the MD-OC during vascular mobilization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Cryptogenic hemifacial spasm. A neurophysiological study.

Whether hemifacial spasm (HFS) is due to axono-axonal ephaptic transmission or to facial nucleus abnormal hyperexcitability remains controversial. The neurophysiological hallmark of HFS is the delayed response (DR). This response has an indirect pathway and thus a long latency. It is evoked A) as a distant response in muscles innervated by a facial branch other than the one stimulated, and B) in muscles innervated by the branch stimulated. In this work, 99 single all-or-none DRs of 24 cases of cryptogenic HFS were studied by threshold stimulation of a branch, or of the trunk, of the facial nerve. A) Eighty-eight distant DRs were studied. Fifty-four of them were frequently evoked as double discharges (DDs), or sometimes as multiple discharges, with a 3 to 7 ms interval. A collision technique, using paired stimuli, showed that the second discharge of 12 out of 20 DDs was accompanied by a back-wave due to a proximal ectopic re-excitation on the axon, or to the back-firing of an alpha cell (F-response), or to both. F-waves in HFS were more frequent than in normals or in other facial pathologies. B) Eleven DRs were recorded in muscles innervated by the facial branch stimulated. Some of them persisted when, using a stronger stimulus, the same all-or-none potential was also evoked as a direct response. In other cases both the direct response and the DR were evoked with identical stimulation threshold. The direct-indirect response interval of these 11 DRs was shorter than the normal M-F interval. These findings suggest that, in the case of HFS, axons are interconnected by uni- and bidirectional ephapses. Self-sustained repetitive firing in such a group of axons apparently results from re-excitations occurring both at the ephapse site and at the cellular level (F-responses). Spasm develops when several groups fire together. The changing excitability of the alpha cells modulates the importance of the phenomenon.

Adult↗
PubMed1990

Botulinum toxin in the treatment of hemifacial spasm.

Thirteen patients with disabling idiopathic hemifacial spasm received botulinum toxin A injections to the affected muscles. Previous treatments, including one posterior fossa decompression, had no sustained benefit. There was excellent response in all the patients with improvement in social disability. Local side effects were mild and transient and include mild facial weakness. One patient had mild diplopia. The benefit lasted more than three months. Reinjection resulted in identical efficacy. Botulinum toxin A injection is a useful therapy for Hemifacial spasm.

Botulinum Toxins↗
PubMedDate not supplied

The diagnostic and therapeutic contribution of calcium channel inhibitors (nifedipine) in esophageal spasm.

The effect of nifedipine (10-20 mg) on esophageal motility was tested in 18 patients with clinical esophageal syndrome and radiologic aspect suggesting esophageal spasm. The drug was administered 20-30 min prior to the second radiologic examination. In 3 cases of achalasia the drug was administered in doses of 10 mg/day for 10 days before the second X-ray examination. Fiber esophagoscopy was performed in all the cases. The initial radiologic aspect was favourably influenced by nifedipine administration in 12 cases confirmed as esophageal spasm. The other 6 patients who did not benefit by the test were cases of organic diseases: 2 post caustic stenoses and 4 cases of eso-cardio-tuberal neoplasm. In the 3 cases of achalasia, treatment with nifedipine led to clinical improvement with relaxation of inferior esophageal contraction on radiologic examination. The study demonstrated the favourable contribution of calcium channel inhibitors to the diagnosis and treatment of esophageal motility disturbances.

Diagnosis, Differential↗
PubMed1990

Secretion of tears in patients with hemifacial spasm.

Hemifacial spasm can cause abnormal tear secretion on the affected side. Thirty patients with this disease were examined using the Schirmer's test without topical anesthetic. Twelve of them showed more tear secretion on the affected side than on the unaffected side. The average Schirmer test value was 30.4 +/- 12.3 mm (+/- SD) on the affected side in the patients and 17.4 +/- 10.9 mm (n = 148) in the control subjects (P less than 0.001). Microvascular decompression surgery reduced the hypersecretion of tears. The results suggest that compression of the facial nerve by a blood vessel causes an excitatory stimulus for tear secretion in patients with hemifacial spasm.

Adult↗
PubMed1990

[Selective injury of the vestibular and facial nerves following microvascular decompression procedures for hemifacial spasm: A case report].

Microvascular decompression procedures were carried out to relieve right hemifacial spasm in a 54-year-old man. His facial spasm was satisfactorily cured but he complained of severe vertigo, and slight facial palsy was also shown after the operation. Electronystagmograph disclosed spontaneous horizontal and rotatory nystagmus toward the non-operated (left) side. The postoperative caloric test showed profound dysfunction on the operated side. His hearing was well maintained postoperatively. These findings indicated, in addition to facial nerve injury, that the peripheral portion of the vestibular nerve was selectively damaged by the operative manipulations. It was shown that both the facial and vestibular nerves tended to be injured when the nerve trunk was shifted caudal-to-rostrally due to manipulations in the CP angle. It was stressed that caution should be paid to preserve not only the cochlear but also the vestibular nerve function in cerebellopontine angle manipulations.

Arteries↗
PubMed1989

[Acute strabismus caused by accommodative spasm].

Acute strabismus accommodative spasm about an adult. A 17 years old woman presents an acute strabismus with accommodative spasm. The different diagnostics and treatments are evoked.

Accommodation, Ocular↗
PubMed1989

[Spasm in aortocoronary vein graft].

A case of spasm of saphenous vein aortocoronary bypass graft in a 70-year-old man is reported. Six months after coronary artery bypass grafting for three vessel disease, routine coronary angiography revealed narrowings of RCA just distal to the site of graft insertion and midportion of vein graft for right coronary artery. PTCA was performed for these stenoses, and then spasm of the vein graft occurred in other 2 points. Isosorbide dinitrate administration and balloon angioplasty for spastic parts were tried. No spastic narrowing of the vein graft was seen in angiography on the next day.

Aged↗
PubMed1989

Epidermoid tumor presenting with trigeminal neuralgia and ipsilateral hemifacial spasm: a case report.

A case of epidermoid tumor presenting with a painful tic convulsif was reported. A 35-year old male with trigeminal neuralgia and ipsilateral hemifacial spasm was diagnosed as having an epidermoid by CT and metrizamide CT cisternography and the symptoms were completely eliminated after the operation. In this case, metrizamide CT cisternography was very useful for preoperative diagnosis by demonstrating the characteristic findings of the epidermoid. It should be taken into consideration that there are some cases with trigeminal neuralgia and/or hemifacial spasm whose symptoms are due to brain tumors.

Adult↗
PubMed1989

[MR imaging in infantile spasms].

CT and MRI in 13 patients with infantile spasms were analyzed. Cortical atrophy was found in 8 cases and ventricular dilatation in 9 cases. The patients with severe cortical atrophy or ventricular dilatation had poorer prognosis than the patients with normal CT findings. In addition to cortical atrophy and ventricular dilatation which were shown in CT, MRI revealed poor differentiation of gray and white matters in all cases and periventricular hyperintensity area in 9 patients. Six patients with the periventricular hyperintensity area of grade III and IV had severe developmental delay. With regard to the prognosis, MRI plays a more useful role in detecting intracranial pathology in infantile spasms.

Brain↗
PubMed1989

Calcium and other biochemical alterations induced by masseter spasm following suxamethonium.

Calcium and other biochemical disturbances are reported from the plasma of a child which presented masseter spasm following the administration of suxamethonium during the induction of halothane anesthesia. After masseter spasm, the ionized calcium concentration decreased whereas the total calcium level remained unchanged despite the occurrence of metabolic and respiratory acidosis. Throughout the rest of anesthesia, the total and ionized calcium concentrations continued to decrease. These variations may indicate that complex metabolic and biochemical events influenced the calcium binding to albumin and the calcium transfer into the muscle cells.

Biological Transport↗
PubMed1987

[Blink reflexes in hemifacial spasm with special reference to the synkinetic responses].

Blink reflexes were studied in 20 patients with hemifacial spasm. The latencies of R1 on the affected side was not different from that on the unaffected side in 10 patients who had no previous facial nerve block, but increased in 10 patients with experience of facial nerve block. Synkinetic responses (SR 1, SR 2 and SR 2 c) were observed by the simultaneous recording from the orbicularis oris muscle on the affected side. SR 1 were obtained in all patients (100%), but SR 2 in 18 patients (90%) and SR 2 c in 19 patients (95%). The mean latency of SR 1 was slightly longer than the mean latency of R 1. When the site of stimulation was moved along the eyebrow from the supraorbital nerve approaching to the stylomastoid foramen, the latencies of R 1 and SR 1 became shorter, but R 2 and SR 2 were suppressed with increased latency. Following local anesthesia (xylocaine) to the temporal branch of the facial nerve, SR 1 was abolished with preserved R 1, R 2 and SR 2. On the other hand, R 2 and SR 2 were abolished with preserved R 1 and SR 1 following xylocaine block to the supraorbital nerve. The result suggested that the afferent pathway of SR 1 is the facial nerve (antidromic conduction) and that of SR 2 is the trigeminal nerve. Ephaptic transmission of those antidromic and orthodromic impulses forming a reverberating circuit should be one of the etiological factors in hemifacial spasm.

Adult↗
PubMed1987

[A case of necrosis of a hepatocellular carcinoma, caused by spasm of the celiac artery].

A 54-year-old man was admitted to our hospital complaining of back pain and right hypochondrial pain. Ultrasonography and celiac angiography revealed a large tumor sized 9.4 X 8.1 cm. The tumor appeared hypervascular on angiogram. During the second angiography, an attempt at superselective hepatic angiography for the purpose of infusing a combination of Adriamycin and Lipiodol, spasm of the celiac artery occurred. High fever continued for 11 days after the spasm and serum transaminase was elevated. At the third angiography, the nature of the tumor was seen to have changed remarkably to one of hypovascularity. Percutaneous transhepatic tumor biopsy was done. Pathological diagnosis was necrosis of hepatocellular carcinoma. Due to heart disorders, ligation of the right hepatic artery was performed instead of hepatic resection. Postoperatively, the size of the tumor decreased further. It is thought that this patient had a tendency to suffer from vasospasm and that the tumor had a relatively low resistance to ischemia.

Carcinoma, Hepatocellular↗
PubMed1987

[Measurement and clinical significance of the posterior cranial fossa volume of patients with hemifacial spasm].

The etiology of hemifacial spasm had long been obscure until 1962 when Gardner proved that this hyperdysfunction of the facial nerve was caused by mechanical compression of the facial nerve by vascular structures in the posterior cranial fossa. In 1977, Jannetta proposed a specific location at the root entry zone of the facial nerve; this area has consequently been considered to be especially vulnerable to minor trauma such as vascular compression. In patients with hemifacial spasm, the posterior cranial fossa cavity is commonly found to be small or shallow on plain craniogram; this anatomical change in the skull is regarded as pathognomonic for the facial nerve hyperdysfunction. To make a quantitative analysis of the posterior cranial fossa volume in these patients, the following method was used. In the preliminary study, a dry human skull with an artificial "tentorium" made of thick paper was prepared to decide the fundamental plane for volume measurement by CT scan. This plane included attachments of posterior clinoid ligaments, superior petrosal veins and lateral sinuses. When this fundamental plane was projected to the lateral view on CT scan, it appeared to be almost identical to the line connecting the tip of posterior clinoid process to the internal occipital protuberance (the fundamental line). A horizontal CT scan for an intracranial volume measurement was performed in a parallel fashion to this fundamental line, with a 5 mm slice for the infratentorial and a 10 mm slice for the supratentorial area. The intracranial area of each horizontal slice was calculated by computed planimeter.(ABSTRACT TRUNCATED AT 250 WORDS)

Cephalometry↗
PubMedDate not supplied

Brainstem lesions due to granular ependymitis in symptomatic diffuse esophageal spasm: a case report.

An 80 year-old man had symptomatic diffuse esophageal spasms for a few months. They were documented by radiographic, endoscopic and manometric findings. The post-mortem neuropathological examination showed a granular ependymitis of the fourth ventricle involving the dorsal region of the motor dorsal nuclei of the vagus nerve which showed frank neuronal loss. The muscular wall of the esophagus, its myenteric plexus and the fasciculi of the vagus nerve were histologically normal. This is the first published case of such a brainstem lesion associated with symptomatic diffuse esophageal spasms. These pathological data are compared with those already published on achalasia.

Aged↗
PubMed1985

Painful muscle spasm reversed by magnesium sulphate. A case report.

A 25-year-old paraplegic man who had sustained a T3/T4 vertebral compression fracture 3 years previously presented with severe, painful spasm of the left hamstring muscle group of 2 hours' duration. This spasm produced extreme knee flexion of a degree which held the left foot posterior to the right buttock. An intravenous injection of 2 g magnesium sulphate produced immediate relief. Possible mechanisms of action of magnesium are discussed.

Adult↗
PubMed1985

[Statistical study of the basic angle and intensity of spasm in functional esotropia (surgical consequences)].

In esotropia surgery all statistical results give the correlation between the amount of the operative correction and the angle of deviation; but this last entity is without value, because a consistent deviation nearly ever exists in spite of protracted medical management; indeed it is usual to notice large spatial variations. In a prospective series of 122 cases the authors have carefully studied the basic angle, the amount of angular variations which give evidence of the strength of spasm, the deep narcosis angle and the muscle elongation test. The various statistical correlations are analyzed. It appears that the basic angle and the strength of spasm are two essential connected but distinct characteristics of innervational imbalance, and it is necessary to carefully evaluate each one. There exists a highly significant correlation between the degree of innervational troubles and the frequency of visco-elastic impairments. The authors make several statements about medical management, early surgery and one-step surgery. They give new guidelines for their operative plan with the Faden operation.

Anesthesia, General↗