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Pathophysiology of hemifacial spasm

  • Chapter
Hemifacial Spasm

Summary

The results of studies in patients undergoing microvascular decompression to relieve hemifacial spasm have provided considerable evidence that the symptoms and signs (spasm and synkinesis) of this disorder are results of changes in the function of the facial motonucleus. Results of animal experiments show that similar signs may develop after chronic electrical stimulation of the facial nerve or after the facial nerve has been injured slightly (by placing a chromic suture around it) and a blood vessel brought into close contact with the nerve. Injury alone or a close contact with a blood vessel alone does not cause the development of such signs.

There is considerable evidence that vascular compression of cranial nerves (V, VII, VIII, IX, and X) occurs frequently without causing any noticeable symptoms or signs of hemifacial spasm. This support the hypothesis that vascular compression alone does not cause any noticeable symptoms but that another factor is also necessary. It is not known what that other factor may be. It could be a slight injury of the respective nerve or a predisposition in the respective nucleus or both. Since vascular compression seems to be necessary (although not sufficient) to cause symptoms, microvascular decompression is an effective treatment, since the other factor(s) do not seem to cause any noticeable symptoms or signs.

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Author information

Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Aage R. Møller Ph.D.

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  1. Aage R. Møller Ph.D.
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Editors and Affiliations

  1. Hôpital Neurologique, Lyon, France

    Marc Sindou

  2. Hôpital Henri Mondor, Creteil, France

    Yves Keravel

  3. Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, USA

    Aage R. Møller

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Møller, A.R. (1997). Pathophysiology of hemifacial spasm. In: Sindou, M., Keravel, Y., Møller, A.R. (eds) Hemifacial Spasm. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6829-5_7

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  • DOI: https://doi.org/10.1007/978-3-7091-6829-5_7

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7416-6

  • Online ISBN: 978-3-7091-6829-5

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