El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial (EHF), en los cuales se realizó una. Request PDF on ResearchGate | Espasmo hemifacial y arte egipcio | El espasmo hemifacial (EH) se caracteriza por la presen-cia de contracciones. Request PDF on ResearchGate | Descompresión microvascular para el espasmo hemifacial 10 años de experiencia en el Instituto Nacional de.
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Semantic Scholar extracted view of "Descompresión microvascular para el espasmo hemifacial. Experiencia de 10 años" by Rogelio Revuelta Gutiérrez et al. of hemifacial spasm (HFS), a retrospective analysis of patients treated at the toxina botulínica tipo A no tratamento do espasmo hemifacial: 11 anos de. Comentario al trabajo: Espasmo hemifacial como presentación clínica de meningiomas intracraneales. Presentación de tres Download PDF. P. Miranda, R.D.
N England J Med; Controlled trial of botulinum toxin injections in the treatment of spasmodic torticollis. Neurology Jan;39 1 Use of botulinum toxin type A in the treatment of cervical dystonia.
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No MRI angiography sequences were obtained. Figure 2. We identified a point of contact with the PICA red arrow at the site of emergence of the right seventh cranial nerve long white arrow. The scan through the right internal auditory canal shows an elongated vessel double white arrow , corresponding to the AICA, in contact with the right seventh and eighth cranial nerves. The dotted white arrow points to the site of emergence of the right seventh and eighth cranial nerves.
To complete the study, we performed an electromyography EMG of the right orbicularis oris muscle, which revealed baseline tonic activity with clusters of increased muscle fibre recruitment coinciding with clonic spasms. We also requested hearing tests and auditory evoked potentials, which revealed no significant alterations. Hemifacial spasm was treated with infiltrations of 7.
As described previously, our patient simultaneously presented 2 different clinical entities with the same aetiology: the neurovascular contact involving structures in the posterior fossa. Intercurrent vestibular alterations have been described in some patients with hemifacial spasm, as have vestibular symptoms secondary to decompression of the seventh cranial nerve. Hemifacial spasm presents very specific symptoms and diagnosis is relatively simple.
In , Campbell and Keedy suggested that vascular abnormalities in the posterior fossa might be associated with HFS. One of the nine HFS patients It has been suggested that hypertension may be a risk factor for HFS, as elevated blood pressure may cause atherosclerosis and hence give rise to ectatic vessels and subsequent compression of the facial nerve.
However, the cause and effect of hypertension in HFS has not been clarified. A review of the literature suggests that an underlying space occupying lesion such as tumour causing HFS is not common. There is electrophysiological evidence that compression of the nerve at the root exit zone is responsible for HFS. Nielsen demonstrated that in HFS, stimulation of the zygomatic branch of the compressed facial nerve results in the expected response in the orbicularis oculi muscle but also a simultaneous response in the mentalis muscle, which is supplied by the mandibular branch.
This phenomenon is absent in controls, and is resolved after surgical decompression of the facial nerve. Solid line demonstrates plane of the left facial nerve at the cerebellopontine angle MRI. Figure 4. Differential diagnosis Involuntary facial movements are not uncommonly encountered in the general population.
As facial twitches are frequently attributed to stress and anxiety, the diagnosis of HFS may be missed. Other aetiological causes of involuntary facial movements such as tardive dyskinesias, myokymia, tics, cranial dystonia, and psychogenic facial spasm must be differentiated from HFS, as early diagnosis allows institution of appropriate treatment Table 1.
Facial myokymia is manifested clinically by involuntary undulating movements of the facial muscles. The eyelids are frequently involved.
Facial tics may affect the facial muscles but other body regions are commonly involved. These movements may be preceded by premonitory symptoms, and are quick and stereotypical, but frequently vary in intensity, and alternate between left and right sides.
Tics may be partially suppressible. Patients suffering from Tourette's syndrome have both motor and vocal tics associated with behavioural symptoms. In blepharospasm, there is bilateral, frequently symmetrical and synchronous contractions of the orbicularis oculi. The frontalis and corrugator muscles as well as other facial muscles may also be affected.