Electrophysiological determination of the site involved in generating abnormal muscle responses in hemifacial spasm

Muscle Nerve. 1998 Aug;21(8):1013-8. doi: 10.1002/(sici)1097-4598(199808)21:8<1013::aid-mus5>3.0.co;2-b.

Abstract

In patients with hemifacial spasm (HFS), abnormal muscle responses due to abnormal cross-transmission are observed in facial muscles. However, the site in the facial nerve responsible for the cross-transmission remains a matter of controversy. We have developed a model in which by considering the electrophysiological parameters involved in producing the abnormal muscle response, we can determine the site of the abnormal cross-transmission within the facial nerve. This model was applied to HFS patients with three different etiologies: idiopathic, post-Bell's palsy, and post-XII-VII anastomosis. Our data show that: in idiopathic HFS, the cross-transmission may occur in the facial nerve at the level of the pontocerebellar angle; in post-Bell's palsy, it is inside the petrous bone; and in XII-VII anastomosis, it must be in the extracranial part of the facial nerve. The possible mechanisms for this cross talk are discussed in terms of ephaptic transmission or of a central hyperexcitability in the facial motor nucleus.

MeSH terms

  • Adult
  • Aged
  • Electrophysiology
  • Facial Muscles / innervation
  • Facial Muscles / physiology*
  • Facial Nerve / physiopathology*
  • Facial Nerve Injuries*
  • Facial Paralysis / diagnosis
  • Facial Paralysis / physiopathology*
  • Female
  • Hemifacial Spasm / diagnosis
  • Hemifacial Spasm / physiopathology*
  • Humans
  • Hypoglossal Nerve / physiopathology
  • Male
  • Middle Aged
  • Neural Conduction / physiology