No abstract available.
Hemifacial Spasm*

No abstract available.
Hemifacial Spasm*

Vestibular Paroxysmia and facial spasm may be caused by vascular compression of the vestibular and facial root entry zone. We report a case of paroxysmal nystagmus accompanied by facial spasm and which is well visualized by three-dimensional reconstruction images. The 3-dimensional reconstruction image supports the view that vestibular paroxysmia may occur with hemifacial spasm simultaneously due to vascular compression.
Hemifacial Spasm ; Spasm

No abstract available.
Hemifacial Spasm* ; Parotid Gland*

No abstract available.
Blinking* ; Facial Nerve* ; Hemifacial Spasm*

On the proposed fluorescein clearance test by Pflugfelder and Tseng, measurements of volume and concentration of instilled fluorescein, being changed by tear secretion, pumping action, during confined time, are able to discern tear turnover rate(tear clearance). We performed TBUT, Schirmer test and modified FCT to the 60 eyes of healthy person, to the 36 eyes of essential blepharospasm patient, and to the 32 eyes of hemifacial spasm patients. We modified the FCT to economize time. Under the topical anesthesia with 0.5% propacaine, test was performed after instilling a 20 microliter of Flucaine(0.25% fluorescein sodium, and 0.5% propacaine) into the conjunctival sac and standard Schirmer strip was then placed for another 10 minutes. The length of the portion was measured and the concentration of tint fluorescein was graded into 5 degrees(photodocumented classification under the cobalt blue light)(FCT 1). Waiting 10 minutes, a standard Schirmer strip was placed into with nasal stimulation and length and concentration was also measured(FCT 2). The agreement of classification was determined with Kappa values for evaluation for reproducibility and and reliability of FCT. The intra-observer agreement(examination repeated twice) was k=0.84 and the inter-observer agreement(two obsevers' examination) was k=0.77, which revealed a consistent result. Patients with blepharospasm was indicated decreased basal secretion compared with normal control(p<0.001) and also showed delayed tear clearance whith represented significant increased concentration(p<0.001). We concluded that FCT was revealed high reproducibility by intra-observer and inter-observer agreement and test may be useful diagnostic method to evaluate delayed tear clearance.
Anesthesia ; Blepharospasm* ; Classification ; Cobalt ; Fluorescein* ; Hemifacial Spasm ; Humans ; Tears

A series of 61 cases of primary hemifacial spasm have been evaluated by means of blink reflex and needle electromyography and their result compared with unaffected site. The R1 and R2 response and late acti-ity. After activity in blink reflex. And electrical activity in EMG at rest were observed. The results of study were as in the followings: 1) The arnplitude of large R1 and R2 responses were increased in affected side in contrast to unaffected side. 2) late activity(72.2%) and after activity(83.6%) were observed in only affected side at rela-ti-ely Iong duration, as well as regular interval spontaneous repetivive discharges in EMG at rest. This result of large R1 and R2 responses could be compatible with ephaptic ransmission, but late activity, after activity, and spontaneous repetitive MUPs could be explained hyperexcitability of the facial motor nucleus rather than autoexcitation of peripheral facial nerve. Additionally the authors thought that the use of conventional blink reflex as well as specialized blink reflex tests could be very useful for the diagnosis of hemifacial spasm and for the evaluation of it's course.
Blinking* ; Diagnosis ; Electromyography* ; Facial Nerve ; Hemifacial Spasm* ; Needles

Forty-one patients with hemifacial spasm received botulinum A toxin in total 73 visits. In 68 of 73 visits(93%), substantial improvement with peak effect(change in severity of hemifacial spasm 22 ) was obtained, with a mean total dose of 12.5 units. Mean severity of hemifacial spasm before and after treatrnent were 3.8 and 1.1 respectively on a 0-5 scale. Mean muscle dose of orbicularis oculi was 9.0 units There was a significant association between muscle dose and post-treatment weakness of orbicularis oculi(Spearman correlation coefficient, 0.42691). There was also a striking and significant association between post-treatment weakness of orbicularis oculi and peak effect(Spearman correlation coefficient, 0.74883). Lagophthalmos occurred only in 2 of 28 visits (7%) who received lesser than 10.0 units for orbicularis oculi as compard to 22% in the higher dose group. But peak effects showed no significant difference between the two groups(p =O.I30). We suggest that the occurrence of lagophthalmos can be reduced with the dose lesser than 10.0 units for orbicularis oculi, maintaining the significant effect.
Botulinum Toxins, Type A* ; Hemifacial Spasm* ; Humans ; Strikes, Employee

PURPOSE: To investigate the applicability of the new three-dimensional overlapped reconstruction MR angiography (3-D ORMRA) technique in patients with hemifacial spasm and to compare the new 3-D reconstruction images with conventional MRA source images. MATERIALS AND METHODS: The study group comprised 27 patients with surgically proven hemifacial spasm. In all patients, conventional MRA source images and 3-D fast imaging employing steady-state acquisition (FIESTA) images were obtained prospectively. After 3-D MR angiographic images were obtained, the 3-D MRA and FIESTA images were overlapped at the workstation by using GE A/W 4.2 add/sub software. We analyzed the relationship between the offending vessels and root exit zone of the facial nerve using both 3-D ORMRA images and conventional MRA source images. RESULTS: In 25 of 27 patients, the offending vessel at the REZ of the facial nerve could be correctly identified on conventional MRA source images. In all patients, the presumed offending vessels depicted by the overlapped 3-D reconstruction MRA image corresponded well with the intraoperative findings. The 3-D reconstruction image showed more clear visualization of the spatial relationship between the offending vessels and the root exit zone of the facial nerve. CONCLUSION: The overlapped 3-D reconstruction MR angiography technique is very useful and informative in patients with hemifacial spasm, as compared with conventional MRA angiography technique.
Angiography ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Prospective Studies

A rare case of hemifacial spasm caused by an ipsilateral tentorial meningioma is described. Magnetic resonance imaging showed a huge tumor in the right cerebellar hemisphere, distant to the cerebello-pontine cistern. The facial-vestibulocochlear nerve complex was stretched by the shift of the brainstem and the right cerebello-pontine cistern was effaced. After removing the tumor, the hemifacial spasm resolved completely. We review our case with the pertinent literature regarding the etiological mechanism.
Brain Stem ; Hemifacial Spasm ; Infratentorial Neoplasms ; Magnetic Resonance Imaging ; Meningioma