Asynchronous blepharospasm, facial and cervical dystonia, and bilateral asynchronous hemifacial spasm

Katz, Bradley J.; Burroughs, John R.; Anderson, Richard L.; Bownds, Shannon; McCann, John D.

doi:10.1002/mds.21221

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…The spasms begin in adult life, around 45 years of age, and prior history of peripheral facial paralysis or traumatic nerve injury is not uncommon. [ 6 16 17 24 44 55 72 ] In a large series, motor nerve dysfunction was verified in 57% of cases. [ 6 ] Synkinesis has been reported in 70% of cases with HFS.…”

Section: Resultsmentioning

confidence: 99%

“… Blepharospasm consists of symmetrical, synchronous, and bilateral contractions of the orbicularis oculi muscle, and may be associated with contractions of the frontalis muscles and the corrugator and procerus muscles, resulting in characteristic depression of the eyebrows (Charcot's sign). [ 44 ] There is no evidence of the Babinski-2 sign, present in the HFS, which is characterized by unilateral contraction of the frontalis muscle, causing eyebrow elevation, with simultaneous contraction of the ipsilateral orbicularis oculi muscle, resulting in eyelid closure[ 12 56 104 ] Facial tics usually begin in childhood, though their characteristics can change, they can be controlled voluntarily and they do not improve with rest. Besides the facial nerve, other nerve groups may be involved, a finding observed in younger patients.…”

Section: Resultsmentioning

confidence: 99%

“…BHFS associated with blepharospasm and associated with cervical dystonia have both been reported. [ 44 92 ]…”

Section: Resultsmentioning

confidence: 99%

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Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Martins¹,

Albuquerque²,

Carvalho³

et al. 2017

Surg Neurol Int

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Background:Bilateral hemifacial spasm (BHFS) is a rare neurological syndrome whose diagnosis depends on excluding other facial dyskinesias. We present a case of BHFS along with a literature review.Methods:A 64-year-old white, hypertense male reported involuntary left hemiface contractions in 2001 (aged 50). In 2007, right hemifacial symptoms appeared, without spasm remission during sleep. Botulinum toxin type A application produced partial temporary improvement. Left microvascular decompression (MVD) was performed in August 2013, followed by right MVD in May 2014, with excellent results. Follow-up in March 2016 showed complete cessation of spasms without medication.Results:The literature confirms nine BHFS cases bilaterally treated by MVD, a definitive surgical option with minimal complications. Regarding HFS pathophysiology, ectopic firing and ephaptic transmissions originate in the root exit zone (REZ) of the facial nerve, due to neurovascular compression (NVC), orthodromically stimulate facial muscles and antidromically stimulate the facial nerve nucleus; this hyperexcitation continuously stimulates the facial muscles. These activated muscles can trigger somatosensory afferent skin nerve impulses and neuromuscular spindles from the trigeminal nerve, which, after transiting the Gasser ganglion and trigeminal nucleus, reach the somatosensory medial posterior ventral nucleus of the contralateral thalamus as well as the somatosensory cortical area of the face. Once activated, this area can stimulate the motor and supplementary motor areas (extrapyramidal and basal ganglia system), activating the motoneurons of the facial nerve nucleus and peripherally stimulating the facial muscles.Conclusions:We believe that bilateral MVD is the best approach in cases of BHFS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Martins¹,

Albuquerque²,

Carvalho³

et al. 2017

Surg Neurol Int

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Painful spasms in facial, masticatory, and motor ocular muscles reversed after microvascular decompression of a neurovascular conflict at brainstem

Idriceanu

Sindou

2017

Acta Neurochir

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The authors present a case of a 42-year-old female admitted for disabling complex and atypical bilateral facial spasms associated with painful masticatory and motor ocular dystonic movements, difficult to fit in the definition of any known cranio-facial dyskinesias. MRI showed a left PICA loop invaginated into the brainstem, considered responsible of an hyperactive disorder of the brainstem nuclei neighboring the conflict. After microvascular decompression, the patient made a full recovery with complete disappearance of the paroxystic phenomena. Such a type of image should be searched for, in an intra-axial brainstem location, in the absence of conflict in the cistern at root entry/exit zone (REZ).

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Synchronous bilateral hemifacial spasm: case-report and literature review

Huang

Xiong

et al. 2018

Acta Neurochir

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Asynchronous blepharospasm, facial and cervical dystonia, and bilateral asynchronous hemifacial spasm

Cited by 3 publications

References 8 publications

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Tenth case of bilateral hemifacial spasm treated by microvascular decompression: Review of the pathophysiology

Painful spasms in facial, masticatory, and motor ocular muscles reversed after microvascular decompression of a neurovascular conflict at brainstem

Synchronous bilateral hemifacial spasm: case-report and literature review

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