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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.12 no.4 São Paulo Dec. 1954 

Decompression of the facial nerve in cases of hemifacial spasm



Karsten Kettel

Chief-Surgeon, Frederiksborg County Hospital, Hillerod, Denmark




Among 11 patients a complete cure was obtained in one case, a fair result in 4 cases, while in 6 cases the effect of the operation has only been temporary and full recurrence has taken place. Even if decompression has thus resulted in a few recoveries and improvements, the results in the majority of cases have been disappointing.
Everything points to hemifacial spasm being due to a disorder of the lower motor neuron. Intracranial lesions in the vicinity of the facial nerve are known to have resulted in irritation and spasm. It may be perfectly true that the majority of cases of hemifacial spasm are due to a lesion, the nature of which may vary, in the Fallopian canal near the stylomastoid foramen, not least the postparalytic following Bell's palsy.
But the disappointing results of decompression seems to indicate that at the time of operation irreparable damage to the nerve has in the majority of cases been already done. Consequently I gave up decompression in cases of hemifacial spasm some years ago.
Good results from injections of alcohol into the nerve have been reported13 but I prefer selective sections of the branches to the muscles involved as described by German and Greenwood8.



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8. German, W. J. - Surgical treatment of spasmodic facial tic. Surgery, 11:912-914, 1942.         [ Links ]

9. Greenwood Jr., J. - The surgical treatment of hemifacial spasm. J. Neurosurg., 3:506, 1946.         [ Links ]

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Relatório apresentado ao XIX Congresso Internacional de Oto-Neuro-Oftalmologia, reunido em São Paulo em 11-17 de junho de 1954, subordinado ao 2º tema oficial: Fisiopatologia do nervo facial.
Postkonto 30279 - Hillerod, Denmark.

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