hemifacial spasm, functional mri

We present a male infant with hemifacial seizures refractory to antiepileptic medication. Hemifacial spasms around the left eye were frequent during wakefulness and sleep since birth. He also had mild psychomotor retardation. Magnetic resonance imaging (MRI) revealed a large tumor in the left middle cerebellar peduncle. Ictal single photon emission computed tomography (SPECT) and ictal (18)F-fluorodeoxyglucose [(18)F-FDG] positron emission tomography (PET) revealed hyperperfusion and hyper glucose metabolism at the tumor...

Peripheral injury of the facial nerve is a frequent disorder. It is a stressful situation for the patient and it is functionally hazardous for the cornea. Facial palsy is due to a lesion involving the facial pontine nucleus or the nerve trunk in its route from the pontocerebellar angle to the parotid. The idiopathic facial paralysis or Bell's palsy (BP) is the most common cause but acute facial palsy can also be due to tumors. A rigorous clinical history and examination must be performed to guide the additional biological, radiological and cochleovestibular investigations in order to reach the diagnosis...

OBJECTIVE: To investigate the correlation between the electrophysiological and radiological findings of primary hemifacial spasm patients. SUBJECTS: Patients with primary hemifacial spasm who had had no botulinum toxin treatment previously were included in the study. DESIGN: In this prospective study patients underwent cerebral magnetic resonance imaging,a magnetic resonance angiography investigation and an electrophysiological examination after informed consent had be given by the patients...

OBJECTIVE: Hemifacial spasm caused by a cerebellopontine angle lipoma is extremely rare. We describe a patient with left-sided hemifacial spasm caused by vascular compression of the facial and vestibulocochlear cranial nerves by the anteroinferior cerebellar artery embedded within a cerebellopontine angle lipoma. CLINICAL PRESENTATION: A 77-year-old man presented with a 10-year history of left-sided facial spasms that progressively worsened over time and significantly interfered with his ability to read, drive, and interact in social situations...

On the occasion of my retirement as head of the Neurochirurgische Universitätsklinik Zürich on 31. May 2007, the changing aspects of neurosurgery in diseases dealt with and in their treatments during the last 70 years (from the foundation of the department by Prof. Krayenbuehl in 1937 successed by Prof. Yaşargil and later on by myself.) were presented. Number of surgical procedures were 1,000 times per year during the interval and the busiest era was that of Prof. Krayenbühl, in which it amounted to as much as 1,500 at the maximum...

The objective of this case study was to describe the clinical and electroencephalography (EEG)/functional magnetic resonance imaging (fMRI) data of a case of isolated hemifacial spasm due to epilepsia partialis continua in a 59-year-old man with abnormal hemifacial movements that disappeared during voluntary tasks, were absent during sleep, and responded to carbamazepine. His neurological examination was normal; EEG revealed right inferior frontal epileptiform discharges. EEG/fMRI demonstrated increased blood oxygenation level-dependent contrast in the right inferior and middle frontal gyri corresponding to the contralateral motor and premotor cortex responsible for facial movements (BA 44, 45, 45, 9), with widespread BOLD signal deactivations suggestive of epileptic network involvement despite a very focal epileptogenic process...

The level of success of neurovascular decompression in ponto-cerebellar angle for hemifacial spasm and trigeminal neuralgia has already established the reality of the pathology to explain such symptoms. However, cochlear nerve compression syndrome by vascular loop is still a controversial topic. We have performed a retrospective cases review with long-term follow-up (5-7 years) concerning the results of microvascular decompression surgery of the cochlear nerve via an endoscopy assisted retrosigmoid approach on 15 patients suffering from unilateral incapacitating tinnitus with abnormal auditory brainstem response and an offending vessel on magnetic resonance imaging...

Bilateral hemifacial spasm (HFS) is a rare movement disorder posing diagnostic doubt with other facial dyskinesias. In this report, we describe clinical, radiological and therapeutic features of 10 patients with bilateral HFS. The prevalence of bilateral HFS in our sample was of 2.6%. Clinical characteristics of our patients did not differ from the classic features of unilateral cases. The mean latency for contralateral facial nerve involvement was of 33.3 months. In only one case a vascular abnormality was seen...

The aim of the study was to clarify the relationship between neurovascular compression of the rostral ventrolateral medulla and arterial hypertension in patients with primary hemifacial spasm. We enrolled 82 patients with primary hemifacial spasm and 82 age- and sex-matched magnetic resonance imaging (MRI) controls of the posterior cranial fossa. Neurovascular compression of the rostral ventrolateral medulla was assessed by MRI, and its association with arterial hypertension was investigated. No significant differences were found in prevalence of arterial hypertension between patients with primary hemifacial spasm and control subjects (39...

A 53 year old lady with diabetes mellitus presented with right hemi-facial spasm (HFS). Brain MRI Scan revealed extensive pan-sinusitis and mild bilateral mastoiditis. She responded well to intravenous ceftriaxone therapy and the hemifacial spasm resolved. The symptoms of hemifacial spasm and pain over the right cheek and peri-orbital area recurred after three weeks. She was admitted to hospital for Functional Endoscopic Sinus Surgery (FESS); following findings on repeat para-nasal sinus CT-Scan. Several reviews over six month's period revealed complete resolution of hemi facial spasm symptoms save for mild intermittent right blepharospasm; particularly on exposure to wind...

OBJECTIVE: To report a case of temporal lobe epilepsy with clinical presentation of paroxysmal episodes of "tightness" over the right hemiface, and ictal crying, and review electroclinical localisation of this phenomenon. METHODS: Clinical semiology, neurophysiological localising tests, and epilepsy surgery outcome are reported in a subject presenting with paroxysmal right hemifacial movements and ictal crying. Pertinent past reports of somato-motor signs and ictal crying in temporal lobe epilepsy are reviewed and the findings correlated with proposed human facial cortical representation...

The authors describe an acute facial and acoustic neuropathy following gamma knife surgery (GKS) for vestibular schwannoma (VS). This 39-year-old woman presenting with tinnitus underwent GKS for a small right-sided intracanalicular VS, receiving a maximal dose of 26 Gy and a tumor margin dose of 13 Gy to the 50% isodose line. Thirty-six hours following treatment she presented with nausea, vomiting, vertigo, diminished hearing, and a House-Brackmann Grade III facial palsy. She was started on intravenous glucocorticosteroid agents, and over the course of 2 weeks her facial function returned to House-Brackmann Grade I...

BACKGROUND: Microvascular compressions of the cochlear nerve can lead to hearing loss. Due to the tonotopic organization of the cochlear nerve any focal compression of the cochlear nerve will result in a frequency specific hearing loss. Decompressing the cochlear nerve could result in a frequency specific hearing improvement, without improving overall hearing. METHOD: Thirty one patients underwent microvascular decompression operations of the vestibulocochlear nerve for vertigo or tinnitus...

INTRODUCTION: Bilateral hemifacial spasm (HFS) is rare. Clinico-radiologic correlates utilizing advanced imaging techniques have not been systematically examined in bilateral HFS. The prevalence of bilateral HFS in an Asian population has not been clarified. OBJECTIVES: We examined the prevalence and clinico-radiologic correlates of bilateral HFS in a clinic-based cohort and compared the clinical characteristics of unilateral HFS patients with and without contralateral neurovascular contact (NVC) in HFS...

RATIONALE AND OBJECTIVES: Neurovascular compression syndromes are currently examined with 2-dimensional representations of tomographic volumes. To overcome this drawback, coarse segmentation followed by direct volume rendering of magnetic resonance (MR) data is introduced supporting a detailed 3-dimensional analysis of the related structures. MATERIALS AND METHODS: This approach is based on MR-CISS (constructive interference in steady state) volumes providing the required high resolution to achieve an improved spatial understanding...

Seven patients with schwannomas of the jugular foramen were included our study in Samsung Medical Center between 1995 and 1999. Patients with neurofibromatosis were excluded. The records of the seven patients (six surgical case and one nonsurgical case) were retrospectively reviewed. There were six women and one man (mean age, 47 years) with a symptom duration ranging from 3 months to 14 years (mean, 47 months). The predominant symptoms were hearing difficulty, hemifacial spasm and hoarseness. Preoperative audiologic evaluation, computerised tomography (CT), magnetic resonance (MR) imaging, and angiography were performed in most patients...

A 54-year-old female and a 49-year-old female presented with complaints of hemifacial spasm. Both patients underwent surgery to remove cerebellopontine angle meningiomas. In one case, no vascular compression was observed at the root exit zone. The tumor was removed subtotally leaving residual tumor adhered to the lower cranial nerves. The hemifacial spasm disappeared immediately after the operation. The residual tumor was treated using gamma knife radiosurgery. In the other case, the root exit zone of the facial nerve was compressed by both the tumor and anterior inferior cerebellar artery and the tumor was removed totally...

OBJECTIVE: To investigate the evolution of cochleovestibular symptoms before, during, and after microvascular decompression (MVD) of the facial nerve in hemifacial spasm. STUDY DESIGN: Prospective study in patients with hemifacial spasm. Among our 13 patients who underwent MVD of the facial nerve from 1995 to 1997, 6 had associated cochleovestibular disorders confirmed by neurotologic tests. RESULTS: In four of these patients, a concomitant compression of the eighth and facial nerves was found at surgery...

Twelve patients underwent microvascular decompression by retrosigmoid approach to relieve severe hemifacial spasm. The surgery was done under intraoperative monitoring of the auditory function. Assessment at Day 2, Day 10, 2 months and 6 months after the operation found that the surgery had resulted in 9 recoveries, 3 improvements and 1 failure. Brain stem auditory evoked potentials monitoring showed that the interposition of Teflon between the vascular loop and the facial nerve is a critical stage for the auditory function...

BACKGROUND: Intracranial epidermoid cysts are slow-growing congenital neoplasms that usually spread and adhere to critical neurovascular structures along the basal cistern, particularly the cerebellopontine angle (CPA) and parasellar region. Clinical symptoms include trigeminal neuralgia, headache and dizziness, progressive hemiparesis, unstable gait and hemifacial spasm. With the aid of modern imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), an effective microsurgical approach can be planned preoperatively to completely remove tumors and avoid complications...