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At least 1,459 records · Page 81Linked to original sources
PubMed1995

[Hemifacial spasms--clinical picture, diagnosis and treatment].

A rectrospective study of 23 consecutive patients with hemifacial spasm is presented. Based on this experience, a practical approach to the diagnosis, investigation and treatment with injections of botulinum toxin is described. Magnetic resonance imaging angiography of the brain was performed in 20 patients an 15 controls. Contact between an artery from the vertebrobasilar circulation and the intracranial part of the facial nerve was observed ipsilaterally to the spasm in 17 patients (85%) and in two controls (7%). Treatment with botulinum toxin was performed in 16 patients with moderate to good improvement in the majority of the patients. MR-angiography is recommended in order to exclude infrequent etiologies and as preoperative evaluation. Botulinum toxin injection is recommended as the symptomatic treatment of choice. The possibility of curative surgical intervention by microvascular decompression of the facial nerve is discussed.

Adult↗
PubMed1995

[A case of atypical hemifacial spasm without involvement of orbicularis oculi muscles: possibility of functional topography in facial nerve].

We reported a case of atypical hemifacial spasm that did not involve orbicularis oculi muscles. A 60-year-old woman suffered from intermittent involuntary movement of the orbicularis oris and buccinator muscles. Operative findings revealed that the rostrodorsal portion of the facial nerve root was compressed by a loop of AICA. Transposing this AICA, it was found that it was compressing one portion on the rostrodorsal part of this nerve root. In most cases, facial spasm involves orbicularis oculi muscles and compression of the anatomically caudal portion of the facial nerve root. Differentiation of the compressed portions of the nerve, therefore, may indicate a functional topography of the facial nerve.

Facial Muscles↗
PubMed1994

Prophylactic use of intravenous prostaglandin E1 for radial arterial spasm in uremic patients undergoing construction of arteriovenous hemodialysis fistulas.

Radial arterial spasm in uremic patients undergoing construction of internal arteriovenous (AV) dialysis fistulas was investigated transcutaneously using ultrasonic Doppler flowmetry. In 6 of 16 control patients, the radial arterial blood flow was significantly decreased for 20 min after anastomosing, indicating vasospasm. Vasospasm did not occur in 15 patients who were continuously administered prostaglandin E1 (PGE1) intravenously (10 ng/kg/min) during surgery. The arterial blood flow was significantly increased in patients receiving PGE1 in comparison with control patients not receiving PGE1 and in whom vasospasm did not occur. Regarding patency of hemodialysis access, the fistula was obstructed in one control patient with radial arterial spasm, but not in patients with PGE1 infusion. Our study suggests that PGE1 may be effective in preventing vasospasm in patients undergoing placement of internal AV dialysis fistulas.

Adult↗
PubMed1993

[Hemifacial spasm treated with botulinum toxin].

Botulinum toxin produces a transient presynaptic focal block at the neuromuscular junction. Thus it induces muscle weakness which has a significant beneficial effect on hemifacial spasm. Fifty-four patients were treated and received at least 2 and at the most 22 consecutive injections over a 5-year period. Injections were repeated every 9 weeks on average. The interval between injections corresponded to the time elapsed between the last injection and the re-emergence of spasms. Nineteen patients abandoned the treatment for various reasons. The most frequent side-effect was a ptosis which was observed in 1 out of 6 injections. Ptosis is due to diffusion of the botulinum toxin over a territory larger than expected. The results obtained in 42 patients were analyzed: there was no effect in 7 patients (17%); 11 patients improved by less than 50%; 13 by 50 to 70% and 11 more than 75%.

Adult↗
PubMed1994

[A case of 15p tetrasomy associated with infantile spasms].

A seven-year-old boy with a 15p tetrasomy: [47, XY, + inv dup (15) (pter-->q13: :q13-->pter)] was reported. The clinical manifestation were as follows; infantile spasms, delayed development and slightly brownish coloured skin. But there were no other abnormal findings in neurological or physical examinations. This was the first case with 15p tetrasomy and infantile spasms.

Child↗
PubMed1994

The straight cervical spine: does it indicate muscle spasm?

The loss of cervical lordosis in radiographs of patients presenting with neck pain is sometimes ascribed to muscle spasm. We performed a cross-sectional study of the prevalence of 'straight' cervical spines in three populations: 83 patients presenting to an accident department with acute neck pain, 83 referred to a radiology department with chronic neck problems, and 80 radiographs from a normal population survey carried out in 1958. Curvature was assessed on lateral radiographs both subjectively and by measurement. The prevalence of 'straight' cervical spines was 19% in the acute cases and 26% in the chronic cases. The 95% confidence interval for the difference was -6.4% to +19.3%. In the normal population 42% showed a straight spine, but a further third of these films had been taken in a position of cervical kyphosis; this probably reflects a difference in positioning technique. Women were more likely than men to have a straight cervical spine, with an odds ratio of 2.81 (95% CI 1.23 to 6.44). Our results fail to support the hypothesis that loss of cervical lordosis reflects muscle spasm caused by pain in the neck.

Acute Disease↗
PubMed1993

[Treatment of hemifacial spasm with botulinum toxin].

We injected botulinum toxin to treat hemifacial spasm, and investigated the effects and the patient's impression of this treatment. Average duration of improvement lasted about 3.5 months in both the initial treatment group and the recurrent group. However the patients in the recurrent group received fewer units of botulinum toxin than those in the initial treatment group. Except for local paralysis that disappeared within a month, there were very few complications. Most patient were satisfied with this treatment. We conclude that the treatment of hemifacial spasm with botulinum toxin is both simple and useful.

Adult↗
PubMed1993

Painful tonic spasms associated with subcortical infarction.

The authors describe the case of a patient in whom painful tonic spasms developed as a consequence of a small infarct involving the lateral aspect of the putamen, the external capsule, and the subcortical white matter of the posterior insular region. Possible pathogenetic mechanisms explaining painful tonic spasms are discussed.

Brain↗
PubMed1995

[Botulinum toxin in blepharospasm, in hemifacial spasm, and in cervical dystonia: results in 33 patients].

The effects of botulinum toxin type A were studied in 33 patients with dystonia (12 blepharospasms, 10 hemifacial spasms and 11 spasmodic torticollis). A rate scale was used to evaluate the severity of the dystonic movements, before and two weeks after each injection. Among blepharospasm patients, eight were female and four were male; the mean age was 57.7 years; the mean time of the disease duration was four years. Three had familial history for similar disease; nine were essential and three had used neuroleptic drugs (tardive dystonia). The mean dose used was 51.3 U, with a mean time of beneficial effects of 2.8 months. For 22 injections and reinjections, 14 (63.7%) showed an excellent result, five (22.7%) good and three (13.6%) null. In the hemifacial spasm group, eight were female and two male; the mean age was 52.6 years; the mean time of the disease duration was 7.4 years; eight were essential and two post-paralytic. The mean dose used was 32 U. From the total of 15 injections and reinjections, all of them (100%) had an excellent result, with a mean time of beneficial effect of 3.4 months. Among the cervical dystonic patients, eight were male and three female; the mean age was 44.2 years; the mean time of the disease duration was 12.2 years; six had essential dystonia, three had used neuroleptic drugs and two had familial history for similar disease. The mean dose used was 238.6 U, with the mean duration of effect of 3.5 months. From the total of 20 injections and reinjections, 18 (90%) had good result, one (5%) mild and one (5%) null.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Hemifacial spasm: study using magnetic resonance angiography].

Nine patients with "idiopathic" hemifacial spasm were evaluated with cranial magnetic resonance imaging and angiography. Alterations of the posterior fossa vasculature, possibly related to the facial nerve irritation, were found in 8 patients (88%). Magnetic resonance angiography is a noninvasive procedure and appears to be a sensitive method to evaluate the hemifacial spasm etiology.

Adult↗
PubMed1977

[Painful and transient spasm of the cardioesophageal sphincter (author's transl)].

The writers describe a painful and transient spasm of the lower esophageal sphincter. Clinically, it is a matter of total aphagia, which is painful and prolonged, and occurs during eating; it always responds to medical treatment (rehydratation and antispasmodics), and it does not exceed 48 hours. An X-ray examination is both essential and characteristic: it visualizes the spasm of the lower esophageal sphincter in its full extent, the food gap, the sideration of the thoracic esophagus, and the disappearance of the air pocket. A perfect understanding of these clinical and and radiological signs enables a recognition of the functional nature of this medically curable condition, and thus aids patients of all ages to avoid an unecessary surgical operation.

Aged↗
PubMed1996

[Results of treatment of hemifacial spasm by surgical and endoscopic neurovascular decompression. Analysis of 60 records].

The notion of a neurovascular conflict in the pathogenesis of hemifacial spasm is now well accepted based on evidence obtained from pre-operative imaging and per-operative videoendoscopy of the pontocerebellous angle. We operated 60 patients, 47 women and 13 men, age range 28-79 years, who had hemifacial spasms for 2 months to 30 years. Neurovascular decompression of the facial nerve via the retrosigmoid access was performed using a minimal invasive technique: limited access of short duration, microsurgery, endoscopic and electrophysiologic techniques, positioning of Teflon microsponges between the nerve and the vessels involved. Surgery led to 90% good long-term results with minimal morbidity limited to auditive sequellae in 3.3% of the cases. The site of compression was at the point where the facial nerve emerged in 95% of the cases. Arteries involved were the posteroinferior cerebellous artery (39 cases), the vertebral artery (23 cases) and the anteroinferior cerebellous artery (16 cases). In a third of the cases, the vascular conflict involved more than one vessel. The facial nerve should be isolated from any nociceptive contact to obtain definitive cure.

Adult↗
PubMed1997

Possible role of neurointerventional techniques in the diagnosis of hemifacial spasm.

We used neurointerventional techniques to conduct a functional investigation of the artery responsible for hemifacial spasm in a 48-year-old woman. Insertion of a microcatheter into the posterior inferior cerebellar artery stopped the hemifacial spasm immediately and completely. The artery was verified intraoperatively as the vessel compressing the root exit zone of the facial nerve.

Arteries↗
PubMed1997

[Study of spontaneous resolution of bronchial spasm after methacholine challenge. Comparison of patients with different degree of hyperreactivity].

The study was designed to assess the spontaneous recovery of bronchial spasm induced by methacholine in bronchial challenge tests and to examine the mechanisms and the modalities involved as well as the influence of dosage. The phenomenon was analysed in 32 hyperreactive patients diagnosed as asthmatics by measuring FEV1 as soon as maximum bronchial constriction (PD20) had been achieved and after 5, 10, 15, 30 and 60 minutes. The data obtained were subjected to variance analysis. Results show: 1) as regards duration of spontaneous recovery, that FEV1 returned to pre-challenge levels after 60 minutes in both the severely and moderately hyperreactive patients; 2) as regards onset of regression, that onset depended on the level of sensitivity, occurring after 30 minutes in the severely affected, after 15 minutes in the mild cases; 3) as regards recovery intensity, that in the moderated cases the recovery was more pronounced in the first 15 minutes than subsequently. Data show that the onset and intensity of the spontaneous recovery change according to the degree of sensitivity. That might reflect a greater affinity and/or bonding of methacholine in the muscarinic receptors of the severely affected, but the possibility of a difference in mediator metabolization speed cannot be excluded. In conclusion, research into the recovery of bronchial spasm may contribute to a better understanding of bronchial hypersensitivity and provide new information of value on the diagnosis, pathogenesis and treatment of the condition.

Adult↗
PubMedDate not supplied

[Treatment of spasms of visceral smooth muscles].

A lot of pathophysiological factors can cause increased activation of smooth muscle contractile mechanisms resulting in long-lasting contractions-spasms. They significantly increase the intercellular concentration of calcium ions and/or increase the affinity of thin contractile filaments for them. The most frequently used drugs in the therapy of visceral smooth muscle spasms are substances that relax smooth muscles (with antimuscarinic activity/atropine-like/or with non-specific activity/papaverine-like direct spasmolytics) and analgesics (opioids or nonsteroid antiinflammatory drugs-NSAID). In the treatment of biliary and renal colics NSAIDs for parenteral use were equally or more efficient than spasmolytics or opioid analgesics. Organic nitrates relax smooth muscles efficiently, but this effect is short-lasting due to their rapid liver metabolism. Experiences with other drugs that could be useful in spastic visceral conditions are still scarce (calcium channel blockers, botulinum toxin, metoclopramide etc). Due to diversity of mechanisms of action of spasmogenic factors, further investigations are directed to discovery of more efficient and more selective drugs than these currently used.

Aged↗
PubMed1997

Concurrent trigeminal and glossopharyngeal neuralgia, hemifacial spasm and hypertension by neurovascular compression. Case report.

The case is reported of a 58 year-old man with left-sided trigeminal and glossopharyngeal neuralgia, left hemifacial spasm and arterial hypertension. Preoperative MRI angiography examination showed a massively ectatic left vertebral artery. At operation a multiple neurovascular compression, which is described, was discovered. Microvascular decompression was performed and postoperatively the patient had complete relief from the trigeminal and glossopharyngeal neuralgia, from the hemifacial spasm, and has sustained normal arterial pressure without medication. The value of MRI in diagnosing of neurovascular compression syndromes and pathophysiology of the "so called" arterial hypertension are discussed.

Cerebral Angiography↗
PubMed1976

Alpha-adrenoceptor-mediated coronary artery spasm.

Selective coronary arteriography performed on a 41-year-old woman with angina pectoris demonstrated proximal stenosis of the right and left main coronary arteries that was unaffected by nitrate therapy. To exclude coronary artery spasm, the study was repeated, and a striking increase in the narrowing of the right coronary artery was observed. This 90% stenosis was virtually abolished by pretreatment with intravenously given phentolamine hydrochloride. Prolonged alpha-adrenoceptor blockade with phenoxybenzamine hydrochloride improved the patient's exercise tolerance and postexercise electrocardiographic abnormalities when compared to therapy in matched controls given placebo. These observations suggest that alpha-adrenoceptor-mediated coronary artery spasm may mimic organic lesions at coronary arteriography and may be a factor in the pathogenesis of angina pectoris in some patients.

Adrenergic beta-Antagonists↗
PubMed1996

[Medical imaging research on idiopathic hemifacial spasm].

In order to have a medical imaging examination for idiopathic hemifacial spasm before surgery, we designed a new method by using vertebroarterial DSA and vertebroarterial CTA based on an aired cisternapontis, 36 patients were examined since 1989 and the compression of the facial nerve from brain stem to porus acousticus internus was showed clearly in all the cases. The arteries responsible for the compression were cerebellar inferior posterior (55.6%), cerebellar inferior anterior (44.4%), auditory internus (25.0%) and vertebroarterial (11.1%), 36% of all the cases had more than one responsible arteries, 22.2% cases had only one compression point, 38.9% had two points, 25.0% had 3 and 13.9% had more. 85.7% of the compression points located in the root zone and 14.3% near the porus acousticus internus. 24 cases were treated with decompression surgery, it indicated that the compression conditions just met the medical imaging examinationg results. After surgery the symptom disappeared in 23 cases and remarkably released in one case with no death case. We believed that this method might be helpful to idiopathic hemifacial spasm decompression surgery and other surgeries in the CP angle.

Adult↗