Hostname: page-component-745bb68f8f-mzp66 Total loading time: 0 Render date: 2025-01-12T08:01:43.832Z Has data issue: false hasContentIssue false
  • English
  • Français

Facial Motor Neuron Excitability in Hemifacial Spasm: A Facial MEP Study

Published online by Cambridge University Press:  23 September 2014

Marshall F. Wilkinson  and
Anthony M. Kaufmann
Marshall F. Wilkinson
Affiliation:
Section of Neurosurgery, Health Sciences Centre and University of Manitoba, Winnipeg, Manitoba, Canada
Anthony M. Kaufmann
Affiliation:
Section of Neurosurgery, Health Sciences Centre and University of Manitoba, Winnipeg, Manitoba, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction:

Hemifacial spasm (HFS) may be due to peripheral axon ephapsis or central motor neuron hyperexcitability. Low facial motor evoked potential (MEP) thresholds or MEP responses to single pulse stimulation (normally multipulse stimulation is needed) may support the central hypothesis.

Methods:

We retrospectively compared response thresholds for facial MEPs in 65 patients undergoing surgical microvascular decompression (MVD) for HFS and 29 patients undergoing surgery for skull base tumors.

Results:

Single pulse stimulation elicited facial Mep in up to 87% of HFS patients whereas only 10% of tumor patients responded to single pulse stimulation. When comparing facial MEP thresholds using multi-pulse stimulus trains the voltage required in the HFS group were significantly lower then in skull base tumor patients (p < 0.001). the MEP latencies and amplitudes at threshold stimulation were similar between the two groups.

Conclusions:

these results suggest the facial corticobulbar pathway demonstrates enhanced excitability in HFS.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 2 , March 2014 , pp. 239 - 245
Copyright
Copyright © The Canadian Journal of Neurological 2014

References

1.Jannetta, PJ.Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res. 1970;2: 217–20.Google Scholar
2.Jannetta, PJ, Abbasy, M, Maroon, JC, et al. Aetiology and definitive microsurgical treatment of hemifacial spasm. J Neurosurg. 1977; 47:321–8.Google Scholar
3.Moller, AR, Jannetta, PJ.Microvascular decompression hemifacial spasm: intraoperative electrophysiological observations. Neurosurg. 1985;16:612–18.Google Scholar
4.Moller, AR, Jannetta, PJ.Physiological abnormalities in hemifacial spasm studies during microvascular decompression operations. Exp Neurol. 1986;93:584–600.Google Scholar
5.Moller, AR, Jannetta, PJ.Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm. J Neurosurg. 1987;66:681–5.CrossRefGoogle ScholarPubMed
6.Neilsen, VK.Electrophysiology of the facial nerve in hemifacial spasm: ectopic/emphatic excitation. Muscle Nerve. 1985;8: 545–55.CrossRefGoogle Scholar
7.Neilsen, VK.Pathophysiology of hemifacial spasm: I. Ephaptic transmission and ectopic excitation. Neurology. 1984;34:418–26.Google Scholar
8.Wilkinson, M, Kaufmann, AM.Monitoring of facial muscle motor evoked potentials during microvascular decompression for hemifacial spasm: evidence of changes in motor neuron excitability. J Neurosurg. 2005;103:64–9.Google Scholar
9.Ulkatan, S, Deletis, V, Fernandez-Conejero, I.Central or peripheral activation of the facial nerve? J Neurosurg. 2007;106(3):519–20.Google Scholar
10.Fukuda, M, Oishi, M, Hiraishi, T, Fujii, Y.Facial nerve motorevoked potential monitoring during microvascular decompression for hemifacial spasm. J Neurol Neurosurg Psychiatry. 2010;81:519–23.Google Scholar
11.Fukuda, M, Oishi, M, Takao, T, Hiraishi, T, Sato, Y, Fujii, Y.Monitoring of abnormal muscle response and facial motor evoked potential during microvascular decompression for hemifacial spasm. Surg Neurol Int. 2012;3:118.Google Scholar
12.Fukuda, M, Oishi, M, Hiraishi, T, Fujii, Y.Facial nerve motor-evoked potential monitoring during microvascular decompression for hemifacial spasm. J Neurol. Neurosurg Psychiatry. 2013;81: 519–23.Google Scholar
13.MacDonald, DB.Intraoperative motor evoked potentials? J Neurosurg. 2007;106(3):517–18.Google Scholar
14.Dong, CJ, MacDonald, D, Akagami, R, et al. Intraoperative facial motor evoked potential monitoring with transcranial electrical stimulation during skull base surgery. Clin Neurophysiol. 2005; 116:588–96.Google Scholar
15.Lui, BY, Tian, YJ, Lui, SL, Qiao, H, Zhang, JT, Jia, GJ.Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma. Chin Med J. 2007;120(4): 323–5.Google Scholar
16.Matthies, C, Raslan, F, Schweitzer, T, Hagen, R, Roosen, K, Reiners, K.Facial motor evoked potentials in cerebellopontine angle surgery: technique, pitfalls and predictive value. Clin Neurol Neurosurg. 2011;113(10):872–9.Google Scholar
17.Brocke, J, Irlbacher, K, Hauptmann, B, Voss, M, Brandt, SA.Transcranial magnetic and electrical stimulation compared: does TES activate intracortical neuronal circuits? Clin Neurophysiol. 2005;116:2748–56.Google Scholar
18.Moller, AR.Intraoperative Neurophysiological Monitoring. 3rd ed. New York; Springer; 2011.Google Scholar
19.Wilkinson, MF, Kaufmann, AM.Intraoperative motor evoked potentials? J Neurosurg. 2007;106:517–20.Google Scholar
20.Fernandez-Conejero, I, Ulkatan, S, Sen, C, Deletis, V.Intra-operative neurophysiology during microvascular decompression for hemifacial spasm. Clin Neurophysiol. 2012;123:78–83.Google Scholar
21.Deletis, V, Fernandez-Conejero, I, Ulkatan, S, Constantino, P.Methodology for intraoperatively eliciting motor evoked potentials in the vocal muscles by electrical stimulation of the corticobulbar tract. Clin Neurophysiol. 2009;120:336–41.Google Scholar
22.Ishikawa, M, Ohira, T, Namiki, J, et al. Electrophysiological investigation of hemifacial spasm after microvascular decompression: F waves of the facial muscles, blink reflexes, and abnormal muscle responses. J Neurosurg. 1997;86:654–61.Google Scholar
23.Ishikawa, M, Nimiki, J, Takase, M, et al. Effect of repetitive stimulation on lateral spread and F-waves in hemifacial spasm. J Neurol Sci. 1996;142:99–106.CrossRefGoogle ScholarPubMed
24.Ishikawa, M, Ohira, T, Namiki, J, et al: Abnormal muscle response (lateral spread) and F-Wave in patients with hemifacial spasm. J Neurol Sci. 1996;137:109–16.Google Scholar
25.Moller, AR, Janetta, PJ.Blink reflex in patients with hemifacial spasm: observations during microvascular decompression operations. J Neurol Sci. 1986;72:171–82.Google Scholar
26.Moller, AR, Janetta, PJ.Physiological abnormalities in hemifacial spasm studied during microvascular decompression operations. Exp Neurol. 1986;93:584–600.Google Scholar
27.Moller, AR.Interaction between blink reflex and the abnormal muscle response in patients with hemifacial spasm: results of intraoperative recording. J Neurol Sci. 1991;101:114–22.CrossRefGoogle Scholar
28.Deletis, V, Urriza, J, Ulkatan, S, Fernandez-Cornejo, I, Lesser, J, Mista, D.The feasibility of recording blink reflexes under general anesthesia. Musc Nerve. 2009;39:642–6.Google Scholar
29.Kojima, A, Ohira, T, Takase, M, et al. Long-latency response to transcranial magnetic stimulation in patients with hemifacial spasm. Electroencephalogr Clin Neurophysiol. 1998;109:285–9.Google Scholar
30.Ishikawa, M, Takashima, K, Kamochi, H, Kusaka, G, Shinoda, S, Watanabe, E.Treatment with botulinum toxin improve the hyperexcitability of the facial motorneuron in patients with hemifacial spasm. Neurol Res. 2010;32:656–60.Google Scholar