Espasmo hemifacial: resultados do tratamento cirúrgico em 14 casos

 

Hemifacial spasm: report of 14 cases submitted to surgical treatment

 

 

Rui R. D. Carvalho^I; Salvador V. Oliveira^II; Juan R. C. Rodrigues^II

^IDisciplina de Neurocirurgia da Faculdade de Ciências Médicas da Santa Casa de São Paulo: Professor
^IIDisciplina de Neurocirurgia da Faculdade de Ciências Médicas da Santa Casa de São Paulo: Assistentes

 

 

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RESUMO

Quatorze pacientes com espasmo hemifacial foram submetidos a exploração cirúrgica e neurolise do 7º par craniano no ângulo ponto-cerebelar. Em 7 pacientes havia indubitável compressão do nervo facial por alça anômala da artéria cerebelar anterior e inferior sendo que um paciente também apresentava malformação de Arnold-Chiari. Em um paciente havia aracnoidite envolvendo o nervo. Em 6 outros, o nervo achava-se aparentemente livre. Houve alívio imediato e duradouro do espasmo em 10 pacientes, 2 permaneceram inalterados e um apresentou recidiva após 10 meses. Houve um óbito no pós-operatório imediato, conseqüente a traumatismo craniano por queda do paciente.

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SUMMARY

Fourteen patients with hemifacial spasm were submitted to surgical exposure and neurolysis of the seventh nerve at the cerebellopontine angle. Seven patients had an anomalous anterior inferior cerebellar artery pulsating on the nerve, being present in one patient also Arnold-Chiari malformation. Another patient had chronic arachnoiditis involving the facial nerve. In 6 patients no abnormalities were found in the posterior fossa. There was complete relief of the spasm in 10 patients, 2 were unchanged, 1 had recurrence 10 months later and 1 died in the post-operative period due to head injury sustained during a fall.

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