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Electrophysiological investigation of hemifacial spasm: F-waves of the facial muscles

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Summary

In patients with hemifacial spasm (HFS), the spasm is due to cross-compression of the facial nerve by a blood vessel. There are currently two hypotheses for the mechanism of HFS: 1) the spasm is caused by ephaptic transmission and an increase in excitability at the site of compression; and 2) the spasm is caused by hyperexcitability in the facial nerve nucleus. In peripheral nerves, F-waves, which result from the backfiring of antidromically activated anterior horn cells, have been proposed as indices of proximal motoneuron conduction and anterior horn cell excitability. Enhancement of the F-waves indicates increased anterior horn cell excitability. We have therefore measured F-waves in the facial muscle of HFS patients in order to investigate the exitability of the facial nerve nucleus.

The authors obtained facial nerve evoked responses from 20 HFS patients before microvascular decompression (MVD), 10 HFS patients after MVD and 10 healthy controls. The F-waves, obtained with surface electrodes from the mentalis muscle, were the second response after the M-wave. On the patient's spasm side, the F-wave duration, F/M amplitude ratio and frequency of F-wave appearance significantly increased compared with those of the normal side or healthy controls; minimum latency and chronodispersion did not significantly differ between these groups. In patients whose spasm disappeared completely following MVD, the abnormal muslce response (lateral spread), which is a characteristic sign of HFS, and the enhancement of the F-wave eventually also disappeared. Because of the correlation between HFS and F-waves, the authors' study supports the hypothesis that the cause of HFS is hyperexcitability of the facial motonucleus.

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References

  1. Auger RG, Piepgras DG, Laws ER Jr (1986) Hemifacial spasm: results of microvascular decompression of the facial nerve in 54 patients. Mayo Clin Proc 61: 640–644

    PubMed  Google Scholar 

  2. Ahiron A, Sarova-Pinhas I (1984) The value of F-wave in Bell's palsy — a study of F-wave response in the facial muscles. Electromyogr Clin Neurophysiol 24: 99–106

    PubMed  Google Scholar 

  3. Bischoff C, Schoenle PW, Conrad B (1992) Increased F-wave duration in patients with spasticity. Electromyogr Clin Neurophysiol 32: 449–453

    PubMed  Google Scholar 

  4. Chun-I Huang, Ih-Hsin Chen, Liang-Shong Lee (1992) Microvascular decompression for hemifacial spasm: analysis of operative findings and results in 310 patients. Neurosurgery 30: 53–57

    PubMed  Google Scholar 

  5. Domen K, Saito E, Namiki J, Kimura A, Chino N, Toya S (1990) F-wave of the facial nerve: a preliminary report on its possible clinical application. Facial N Res Jpn 10: 41–44

    Google Scholar 

  6. Drory VE, Neufeld MY, Korczyn AD (1993) F-wave characteristics following acute and chronic upper motor neuron lesions. Electromyogr Clin Neurophysiol 33: 441–446

    PubMed  Google Scholar 

  7. Eisen A, Odusote (1979) Amplitude of the F-wave: a potential means of documenting spasticity. Neurology 29: 1306–1309

    PubMed  Google Scholar 

  8. Esteban A, Molina-Negro P (1986) Primary hemifacial spasm: a neurophysiological study. J Neurol Neurosurg Psychiatry 49: 58–63

    PubMed  Google Scholar 

  9. Ferguson JH (1978) Hemifacial spasm and the facial nucleus. Ann Neurol 4: 97–103

    PubMed  Google Scholar 

  10. Fierro B, Raimondo D, Modica A (1993) F-wave study at different stimulation rates in upper motoneurone lesions. Electromyogr Clin Neurophysiol 33: 27–31

    PubMed  Google Scholar 

  11. Fisher MA, Shahani BT (1978) Assessing segmental excitability after rostral lesions: 1. The F response. Neurology 28: 1265–1271

    PubMed  Google Scholar 

  12. Fisher MA (1991) Inhibition of motoneuron discharge by peripheral nerve stimulation: an F response analysis. Muscle Nerve 14: 120–123

    PubMed  Google Scholar 

  13. Fox JE, Hitchcock ER (1987) F-wave size as a monitor of motor neuron excitability: the effect of deafferentation. J Neurol Neurosurg Psychiatry 50:

  14. Fullerton PM, Gilliatt RW (1965) Axon reflexes in human motor nerve fibres. J Neurol Neurosurg Psychiatry 28: 1–11

    PubMed  Google Scholar 

  15. Gardner WJ (1962) Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19: 947–958

    PubMed  Google Scholar 

  16. Howe JF, Calvin WH, Loeser JD (1976) Impulses reflected from dorsal root ganglia and from focal nerve injuries. Brain Res 116: 139–144

    PubMed  Google Scholar 

  17. Ishikawa M, Namiki J, Gotoh K, Ajim Y, Ohira T, Toya S, Domen K, Chino N (1992) F-wave of the facial muscle at rest and during voluntary contraction. Facial N Res Jpn 12: 183–188

    Google Scholar 

  18. Iwakuma T, Matsumoto A, Nakamura N (1982) Hemifacial spasm: comparison of three different operative procedures in 110 patients. J Neurosurg 57: 753–756

    PubMed  Google Scholar 

  19. Jannetta PJ (1990) Cranial rhizopathies. In: Youmans JR (ed) Neurological surgery, Vol 6. Saunders, Philadelphia, pp 4169–4182

    Google Scholar 

  20. Kimura J (1989) The F-wave. In: Electrodiagnosis in diseases of nerve and muscle: principles and practice. Davis, Philadelphia, pp 332–355

    Google Scholar 

  21. Kimura J (1989) The blink reflex. In: Electrodiagnosis in diseases of nerve and muscle: principles and practice. Davis, Philadelphia, pp 307–331

    Google Scholar 

  22. Kimura J (1992) The blink reflex as a clinical test. In: Aminoff NJ (ed) Electrodiagnosis in clinical neurology, 3rd Ed. Churchill Livingstone, New York, pp 1369–1402

    Google Scholar 

  23. Komori T, Narita S, Matsunaga M, Kurahashi K, Takebe K (1981) F response in spastic spinal paralysis. Clin Neuroi 21: 517–521

    Google Scholar 

  24. Kumagami H (1974) Neuropathological findings of hemifacial spasm and trigeminal neuralgia. Arch Otolaryngol 99: 160–164

    PubMed  Google Scholar 

  25. Kuroki A, Møller AR (1994) Facial nerve demyelination and vascular compression are both needed to induce facial hyperactivity: a study in rats. Acta Neurochir (Wien) 126: 149–157

    Google Scholar 

  26. Milanov IG (1992) F-wave for assessment of segmental motoneurone excitability. Electromyogr Clin Neurophysiol 32: 11–15

    PubMed  Google Scholar 

  27. Møller AR, Jannetta PJ (1984) On the origin of synkinesis in hemifacial spasm: result of intracranial recordings. J Neurosurg 34: 569–576

    Google Scholar 

  28. Møller AR, Jannetta PJ (1986) Blink reflex in patients with hemifacial spasm: observations during microvascular decompression operations. J Neurol Sci 72: 171–182

    PubMed  Google Scholar 

  29. Møller AR, Jannetta PJ (1987) Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm. J Neurosurg 66: 681–685

    PubMed  Google Scholar 

  30. Møller AR, Sen CN (1990) Recordings from the facial nucleus in the rat: signs of abnormal facial muscle response. Exp Brain Res 81: 18–24

    PubMed  Google Scholar 

  31. Møller AR (1991) Interaction between the blink reflex and the abnormal muscle response in patients with hemifacial spasm: results of intraoperative recordings. J Neurol Sci 101: 114–123

    PubMed  Google Scholar 

  32. Møller AR (1991) The cranial nerve vascular compression syndrome: II. a review of pathophysiology. Acta Neurochir (Wien) 113: 24–30

    Google Scholar 

  33. Nakazumi Y, Tani T, Kameyama S, Fuchigami Y, Kimura J (1990) Late response elicited during voluntary contraction: is it an F-wave or an H-reflex. Jpn J EEG EMG 18: 54–59

    Google Scholar 

  34. Namiki J, Nakatsukasa M, Ajimi Y, Tamura K, Shiobara R, Toya S (1989) F-wave of the facial muscle in cat. Facial N Res Jpn 9: 35–48

    Google Scholar 

  35. Namiki J, Ajimi Y, Tamura K, Ohira T, Toya S, Domen K, Saito E, Chino N, Nakatsukasa M (1990) F-wave of the facial muscle in cat: recordings by surface electrodes. Facial N Res Jpn 10: 37–40

    Google Scholar 

  36. Namiki J, Domen K, Saito E, Chino N, Ohira T, Toya S (1991) F-wave of the facial muscles in patients with hemifacial spasm. Facial N Res Jpn 11: 63–68

    Google Scholar 

  37. Nielsen VK (1984) Pathophysiological aspects of hemifacial spasm: Part I. Evidence of ectopic excitation and ephaptic transmission. Neurology (NY) 34: 418–426

    Google Scholar 

  38. Nielson VK (1984) Pathophysiological aspects of hemifacial spasm: Part II. Lateral spread of the supraorbital nerve reflex. Neurology (NY) 34: 427–431

    Google Scholar 

  39. Nielsen VK (1985) Electrophysiology of the facial nerve in hemifacial spasm: ectopic/ephaptic excitation. Muscle Nerve 8: 545–555

    PubMed  Google Scholar 

  40. Ohira R, Moro K (1989) The problems in microvascular decompression for the treatment of hemifacial spasm and electrophysiological monitoring. Facial N Res Jpn 9: 205–208

    Google Scholar 

  41. Panayiotopoulos CP (1979) F chronodispersion: a new electrophysiologic method. Muscle Nerve 2: 68–72

    PubMed  Google Scholar 

  42. Ramon F, Moor JW (1978) Ephaptic transmission in squid axons. Am J Physiol 234: 162–167

    Google Scholar 

  43. Roth G, Magistris MR, Pinell P, Rilliet B (1990) Cryptogenic hemifacial spasm. A neurophysiological study. Electromyogr Clin Neurophysiol 30: 361–370

    PubMed  Google Scholar 

  44. Ruby JR, Jannetta PJ (1975) Hemifacial spasm: ultrastructural changes in the facial nerve induced by neurovascular compression. Surg Neurol 4: 369–370

    PubMed  Google Scholar 

  45. Saito S, Itagaki S, Nakai O (1990) Neurophysiological study on hemifacial spasm: the abnormality and origin of the electromyograpic response to stimulation of the facial nerve. Brain Nerve (Tokyo) 42: 621–627

    Google Scholar 

  46. Sawnhey BB, Kayan A (1970) A study of the F-wave from the facial muscles. Electromyography 3: 287–295

    Google Scholar 

  47. Sen CN, Møller AR (1987) Signs of hemifacial spasm created by chronic periodic stimulation of the facial nerve in the rat. Exp Neurol 98: 336–349

    PubMed  Google Scholar 

  48. Trontelj JV, Trontelj M (1973) F-responses of human facial muscles. A single motoneurone study. J Neurol Sci 20: 211–222

    PubMed  Google Scholar 

  49. Valls-Sole J, Eduardo S, Tolosa (1989) Blink reflex excitability cycle hemifacial spasm. Neurology 39: 1061–1066

    PubMed  Google Scholar 

  50. Woltman HW, Williams HL, Lanbert EH (1951) An attempt to relieve hemifacial spasm by neurolysis of the facial nerves. A report of two cases of hemifacial spasm with reflections of the nature of the spasm, the contracture and mass movement. Proc Staff Meet Mayo Clin 26: 236–240

    Google Scholar 

  51. Wartenburg R (1952) Hemifacial spasm. A clinical and pathophysiological study. Oxford University Press New York

    Google Scholar 

  52. Zappia M, Valentino P, Marchello LP, Paniccia M, Montagna P (1994) F-wave normative studies in different nerves of healthy subjects. Electromyogr Clin Neurophysiol 24: 99–106

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan

    M. Ishikawa, T. Ohira, J. Namiki, K. Gotoh, M. Takase & S. Toya

  2. Department of Clinical Neurophysiology, School of Medicine, Keio University, Tokyo, Japan

    M. Takase

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  1. M. Ishikawa
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  2. T. Ohira
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  3. J. Namiki
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  4. K. Gotoh
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  5. M. Takase
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  6. S. Toya
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Ishikawa, M., Ohira, T., Namiki, J. et al. Electrophysiological investigation of hemifacial spasm: F-waves of the facial muscles. Acta neurochir 138, 24–32 (1996). https://doi.org/10.1007/BF01411719

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