Treatment of Idiopathic Hemifacial Spasm with Radiosurgery or Hypofractionated Stereotactic Radiotherapy: Preliminary Results

Fraioli, Mario Francesco; Moschettoni, Laura; Fraioli, Chiara; Strigari, Lidia

doi:10.1055/s-0030-1247584

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…Idiopathic HFS is a rare disorder with a 1 year prevalence of 1 in 10,000 people [4]. The cause of HFS is unclear, but it may be caused by a lesion such as a tumor, a cyst, an aneurysm, an AV malformation, an intrinsic brain stem lesion, or a bony lesion of the cranium in the cerebellopontine angle [2].…”

Section: Discussionmentioning

confidence: 99%

Intractable Hemifacial Spasm Treated by Pulsed Radiofrequency Treatment

et al. 2013

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Hemifacial spasm is defined as unilateral, involuntary, irregular twitching of all or parts of the muscles innervated by facial nerves. Here, we present a case of recurrent hemifacial spasm after microvascular decompression (MVD) treated with pulsed radiofrequency (PRF) treatment with good results. A 35-year-old woman suffered from recurrent hemifacial spasm after MVD that was refractory to medical treatment and botulinum toxin injections. We attempted a left facial nerve block twice. Then, we applied PRF at a maximum temperature of 42℃ for 120 sec. Some response was observed, so we applied PRF two additional times. The frequency of twitch decreased from 3-4 Hz to < 0.5 Hz, and subjective severity on a visual analogue scale also decreased from 10/10 to 2-3/10. PRF treatment might be an effective medical treatment for refractory hemifacial spasm and has fewer complications and is less invasive compared with those of surgery.

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Section: Discussionmentioning

confidence: 99%

Intractable Hemifacial Spasm Treated by Pulsed Radiofrequency Treatment

et al. 2013

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“…Radiation-induced blockage of the paroxysmal ephaptic transmission in idiopathic trigeminal neuralgia may serve as an explanation for the relief from HFS after GKS. Fraioli et al 4 reported preliminary results of treat-ment of idiopathic HFS using radiosurgery or stereotactic hypofractionated radiotherapy and showed that a low radiation dose (8 Gy) directed to the facial nerve improved HFS. Kida et al 10 observed improvement in 5 of 7 pa- tients with facial or trigeminal nerve hyperfunction, despite the fact that tumor shrinkage was confirmed in only two patients.…”

Section: Mechanism Of Spasm Relief After Microsurgery and Radiosurgerymentioning

confidence: 99%

Gamma Knife surgery for hemifacial spasm related to cerebellopontine angle tumors

Chang¹,

Chuang

Wu³

et al. 2012

JNS

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Object Most cases of tumor-related hemifacial spasm (HFS) are treated by open surgery. The authors report the effects of Gamma Knife surgery (GKS) on benign tumor–related HFS at a mean follow-up time of 84 months. Methods Between 2000 and 2011, 6 patients (5 women and 1 man) harboring single tumors of the cerebellopontine angle (4 meningiomas and 2 vestibular schwannomas [VSs]) and experiencing HFS underwent GKS as a primary treatment. The mean age of the patients at the time of radiosurgery was 52.7 years (range 45–60 years). The patients' tumors lay within the radiosurgical target area. In the 4 cases of meningioma, the mean radiosurgical treatment volume was 5.3 cm3 (range 1.2–9.6 cm3), and the mean radiosurgical tumor margin dose was 14.1 Gy (range 12–18 Gy); in the 2 cases of VS, the treatment volume was 2.5 cm3 in 1 patient and 11.2 cm3 in the other, and the margin doses were 11.5 and 12 Gy, respectively. The mean duration of HFS symptoms was 15.5 months (range 3–36 months). Results The mean follow-up period was 84 months (range 40–110 months). Overall, 4 (66%) of the 6 patients experienced complete relief from HFS without medication after GKS and 1 patient obtained a good outcome. The mean time for improvement to be realized was 12.6 months (range 3–24 months). Only 1 patient failed to experience relief from HFS, and coincidentally, the tumor did not shrink in that case. In all 6 patients (100%), tumor growth was controlled at a mean follow-up of 56 months after GKS: in 5 patients the tumor had decreased in size and in the other patient the tumor size remained unchanged. No new neurological deficit was noted after GKS, and 1 patient with facial numbness reported improvement after tumor shrinkage. Conclusions Gamma Knife surgery appears to be effective in treating benign tumor–related HFS and in controlling tumor growth. A reduction in tumor volume is related to spasm improvement. Although a time latency for spasm relief is associated with GKS, minimal side effects are expected.

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“…12 Entre as modalidades de tratamento, a abordagem clínica com carbamazepina ou toxina botulínica não mostra resultados tão satisfatórios a longo prazo como a descompressão microcirúrgica vascular na fossa posterior do crânio. 4,5,8,14 na intensidade dos espasmos. A tomografia computadorizada com uso de contraste não mostrou achados sugestivos de compressão do nervo facial.…”

Section: Introductionunclassified

“…No entanto, os benefícios da toxina botulínica são transitórios e decrescentes após múltiplas administrações 4 . O procedimento efetivo consiste na descompressão microvascular 4,5,8,14,17 .…”

Section: Introductionunclassified

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Resultados tardios da descompressão microvascular do nervo facial pela artéria vertebral

Brito¹,

Paiva²,

Silva³

et al. 2018

jbnc

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Espasmos faciais constituem afecção rara, caracterizada por contrações assimétricas, involuntárias e paroxísticas da musculatura facial. Frequentemente são de acometimento unilateral e levam a situação desconfortável e prejudicial à qualidade de vida dos pacientes. Na maioria das vezes, o quadro inicia-se gradualmente no músculo orbicular dos olhos, seguindo-se por acometimento do andar inferior da face ipsilateralmente. Os espasmos são causados por compressão vascular, mais comumente provocada pela presença da artéria cerebelosa póstero-inferior (PICA) ou da artéria cerebelosa antero-inferior (AICA) (sendo mais raro o envolvimento da artéria vertebral) sobre a raiz do nervo facial, na REZ (Root Entry Zone). Injeção de toxina botulínica no músculofacial envolvido é uma opção terapêutica medicamentosa, no entanto possui benefícios transitórios ao longo da terapia. A descompressão microvascular é um tratamento efetivo, com baixas taxas de complicação. Descreve-se o caso de um paciente de 65 anos portador de contrações involuntárias e esporádicas da musculatura orbicular do olho esquerdo de caráter insidioso e progressivo. Optou-se por microcirurgia descompressiva com interposição de teflon entre artéria vertebral esquerda e o nervo facial na fossa posterior, com significativa melhora clínica, e regressão progressiva dos espasmos até sua completa remissão.

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Treatment of Idiopathic Hemifacial Spasm with Radiosurgery or Hypofractionated Stereotactic Radiotherapy: Preliminary Results

Cited by 6 publications

References 7 publications

Intractable Hemifacial Spasm Treated by Pulsed Radiofrequency Treatment

Intractable Hemifacial Spasm Treated by Pulsed Radiofrequency Treatment

Gamma Knife surgery for hemifacial spasm related to cerebellopontine angle tumors

Resultados tardios da descompressão microvascular do nervo facial pela artéria vertebral

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