Journal article
Case report of recurrent hemifacial spasm attributed to over-impaction with Teflon sponge
Surgical neurology international, Vol.11(110), p.110
05/16/2020
DOI: 10.25259/SNI_95_2020
PMCID: PMC9115890
PMID: 35592012
Abstract
Background: Hemifacial spasm (HS) is a muscular disorder frequently exacerbated by arterial compression amenable to surgical intervention through microvascular decompression (MVD). Recurrence is a known cause and warrants investigation. Case Description: A 65-year-old woman presented with the left HS of 7 years duration. Her symptoms were initially well controlled with botulinum toxin injections. However, these injections eventually lost their effectiveness, necessitating MVD. At surgery, the anterior inferior cerebellar artery was indenting the facial nerve at its root entry zone. This was carefully dissected away, and several Teflon (polytetrafluoroethylene) felt pledgets were used for decompression. Postoperatively, the patient reported great improvement of her symptoms for 3 months. Gradually her spasms returned, intermittently at first, until finally they became persistent 6 months postoperatively. An MRI was obtained showing elevation and posterior displacement of the VII-VIII complex by the pledgets. After failing to improve, the patient opted for reoperation 10 months after initial MVD. At surgery, the Teflon pledgets were displacing the VII-III nerves posteriorly and superiorly. The Teflon pledgets were dissected free, and the nerve dis-impacted. On her postoperative visit 1 year later, she is spasm free, subjectively, and objectively. Conclusion: This case illustrates the value of re-imaging recurrent HS, and re-exploration with a favorable rkesult.
Details
- Title: Subtitle
- Case report of recurrent hemifacial spasm attributed to over-impaction with Teflon sponge
- Creators
- Scott C. SeamanJennifer NoellerKirill NourskiPatrick W. Hitchon
- Resource Type
- Journal article
- Publication Details
- Surgical neurology international, Vol.11(110), p.110
- DOI
- 10.25259/SNI_95_2020
- PMID
- 35592012
- PMCID
- PMC9115890
- NLM abbreviation
- Surg Neurol Int
- ISSN
- 2152-7806
- eISSN
- 2152-7806
- Language
- English
- Date published
- 05/16/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984256928502771
Metrics
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