Preliminary Study on the Relationship Between Inflammation and Hemifacial Spasm

doi:10.1016/j.wneu.2019.01.044

World Neurosurgery

Volume 125, May 2019, Pages e214-e220

https://doi.org/10.1016/j.wneu.2019.01.044 Get rights and content

Background

Complete pathogenesis of hemifacial spasm (HFS) is unknown. In some patients with HFS, thickened, opaque, and sticky arachnoid membranes have been found during microvascular decompression procedures. This phenomenon indicates a possible relationship between inflammation and HFS. The aim of this study was to explore the role of inflammation in pathogenesis of HFS.

Methods

Levels of interferon-γ, interleukin-2 receptor, interleukin-6 (IL-6), interleukin-8, interleukin-10, and tumor necrosis factor α and white blood cell (WBC), neutrophil, and lymphocyte counts were compared between patients with HFS, patients with lumbar disc herniation, and healthy control subjects. A receiver operating characteristic curve analysis was performed to evaluate the diagnostic significance of peripheral blood inflammatory markers for HFS. All the inflammatory markers were further analyzed by single and multiple logistic regression analysis.

Results

Patients with HFS had greater IL-6, interleukin-8, white blood cell count, and neutrophil count than patients with lumbar disc herniation and healthy control subjects. Area under curve values of IL-6, white blood cell count, and neutrophil count were >0.8. Multiple logistic regression analysis indicated that only interleukin-2 receptor and IL-6 were relevant to HFS.

Conclusions

Inflammation is relative to HFS. IL-6 may be 1 of many factors involved in pathogenesis of HFS.

Introduction

Hemifacial spasm (HFS) is a disease with complex symptoms related to hyperactive motor dysfunction of facial nerve. Although HFS does not directly threaten a patient's life, it causes poor quality of life, a poor social image, and psychological problems.¹ It is generally believed that HFS is caused by vascular compression at the root entry zone of the facial nerve. Microvascular decompression (MVD) of the facial nerve has been widely accepted as a standard treatment for HFS.2, 3, 4, 5 However, in addition to compression of the vessel itself, another contributing factor leading to HFS is adhesion and traction to vessel of adjacent arachnoid membranes. Some studies have stated that only complete separation and dissection of arachnoid membranes can result in sufficient MVD for HFS.6, 7, 8, 9 Moreover, thickened, opaque, and sticky arachnoid membranes have sometimes been observed during surgery for HFS. This phenomenon indicates possible influence on vessel or facial nerves by abnormal arachnoid membranes. Inflammation was considered to be the primary cause for the abnormal appearances of arachnoid membranes.10, 11, 12 However, studies specifically investigating the link between inflammation and HFS are lacking. The aims of this study were to describe the differences in preoperative inflammatory markers between patients with HFS, patients with lumbar disc herniation (LDH), and healthy control subjects and to explore the roles of inflammatory markers in the pathogenesis of HFS.

Section snippets

Patients and Healthy Control Subjects

This study was approved by the institutional ethics committee of Xinhua Hospital Affiliated to Medicine School of Shanghai Jiaotong University. Medical records of patients with a diagnosis of HFS and operated on at Xinhua Hospital between June 2016 and March 2018 were collected and retrospectively analyzed. Each record included in the final analysis met the following criteria: 1) The patient did not previously undergo an MVD operation. 2) The patient did not have HFS with a rare cause,

Study Population

After screening, 142 patients with HFS and 70 healthy subjects in the healthy control group were enrolled in the final analysis. Detailed demographic data of the study participants are presented in Table 1. Age range of patients in the HFS group was 24–86 years old, with median age 52 years old. The HFS cohort consisted of 44 men (30.99%) and 98 women (69.01%). The disease course ranged from 0.01 to 27 years (median 3 years). The median age of healthy control subjects was 61 years old; the

Discussion

HFS is mainly caused by pulsatile neurovascular contact at the root entry zone of the facial nerve.13, 14 However, although neurovascular compression has been identified as the primary cause for HFS, there are still several questions that have not been answered sufficiently. During MVD procedures, compression from vessel to facial nerve could also be influenced by some indirect contributing factors, such as adjacent abnormal arachnoid membranes. Sometimes the arachnoid membranes in patients

Conclusions

In this study, we found that inflammation is relative to HFS. IL-6 may be 1 of many factors involved in the pathogenesis of HFS.

Acknowledgments

The authors thank all the individuals who offered help and advice on this study.

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Cited by (5)

Role of a Tortuous Vertebrobasilar Artery and Anchoring Perforators in the Etiology of Hemifacial Spasm
2024, World Neurosurgery
In >70% of patients with hemifacial spasm (HFS), the offending artery is either the anterior inferior cerebellar artery (AICA) or posterior inferior cerebellar artery (PICA), without a tortuous vertebrobasilar artery (VBA). We hypothesized that anchoring perforators around the root exit zone (REZ) of the AICA or PICA might induce vascular deviation and compression. We investigated the occurrence of these perforators from the AICA or PICA and the extent of VBA tortuosity to reveal the pathology of vascular compression.
This retrospective review included 110 patients after excluding those with vertebral artery (VA) compression alone. The occurrence of perforators was determined according to operative findings within 5 mm of the REZ, and VBA tortuosity was evaluated using MATLAB. We analyzed the association between perforators, VBA tortuosity, and the surgical implications.
The occurrence of perforators from the offending AICA or PICA around the REZ was significantly higher in the group without VA compression (Group A) than in the group with VA compression (Group B). VBA tortuosity was significantly lower in Group A. VBA tortuosity was inversely correlated with the presence of AICA or PICA perforators in all 110 patients. Operative results were similar between the groups, although patients with low VBA tortuosity tended to require interposition in decompression procedures.
Anchoring perforators around the REZ play a crucial role in vascular compression for patients with less tortuous VBAs. Moreover, surgeons should be prepared to deal with multiple perforators in a more complicated surgery in cases of less tortuous VBA.
Evaluation of pre-operative neuroimaging characteristics in patients with primary hemifacial spasm as a prognostic factor of microvascular decompression
2020, Clinical Neurology and Neurosurgery
Citation Excerpt :
These abnormal arachnoid membranes have sometimes been observed during operation for HFS [13,14,21]. Chen et al. have reported that the inflammatory markers, such as IL-6, were related to the pathogenesis primary HFS [13]. The measurement of area revealed that a smaller CPA cistern might be associated with a higher incidence rate of HFS.
The aim of this study was to explore the possible pathogenesis of primary hemifacial spasm (HFS) according to the performances of preoperative high-resolution magnetic resonance (MR) sequence and investigate the correlations between the neuroimaging parameters and the prognosis of microvascular decompression (MVD).
106 patients with HFS and 121 age-matched and gender-matched healthy controls (HCs) were included in this study. Electronic medical records and neuroimaging data were collected. The facial-nerve angle, cross-sectional area of CPA cistern and length of the cistern segment of the facial nerve were measured on affected side and unaffected as well as healthy individuals. The receiver operating characteristic curve was used for assessing the predictive performances.
100 patients achieved complete relief postoperatively. 13 of the 100 complete relief patients developed a relapse in the follow-up. The preoperative facial-pontine angle and cross-sectional area of the CPA cistern on the affected side was significantly smaller than the unaffected side and HC. The facial-pontine angle and the cross-sectional area of the CPA cistern was significantly smaller in recurrent group than the non-recurrent group. The AUC value of both facial-pontine angle and cross-sectional area of the CPA cistern were over 0.7.
Small facial-nerve angle and cross-sectional area of CPA cistern may be regarded as the possible pathogenesis of primary HFS. The measurement of facial-nerve angle and cross-sectional area of CPA cistern preoperatively might be used to predict the surgical effect of MVD.
Mapping trends in hemifacial spasm research: bibliometric and visualization-based analyses of the Web of Science Core Collection
2024, Neurosurgical Review
The Underlying Pathogenesis of Neurovascular Compression Syndromes: A Systematic Review
2022, Frontiers in Molecular Neuroscience
Association Study of Apolipoprotein E Gene Polymorphism With Incidence and Delayed Resolution of Hemifacial Spasm
2021, Frontiers in Neurology

: Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

: Ming Chen, Min Yang, and Wei-ping Zhou are co–first authors.

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Original ArticlePreliminary Study on the Relationship Between Inflammation and Hemifacial Spasm

Background

Methods

Results

Conclusions

Introduction

Section snippets

Patients and Healthy Control Subjects

Study Population

Discussion

Conclusions

Acknowledgments

Surg Neurol

Surg Neurol

Neurobiol Dis

Cytokine Growth Factor Rev

Biochem Biophys Res Commun

Microvascular decompression of the facial nerve for the treatment of hemifacial spasm: preoperative magnetic resonance imaging related to clinical outcomes

Acta Neurochir (Wien)

Microvascular decompression for hemifacial spasm

J Neurosurg

Follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm

Neurosurgery

Neurovascular compression in cranial nerve and systemic disease

Ann Surg

Microvascular compression: an alternative view and hypothesis

J Neurosurg

Hemifacial spasm: neurovascular compressive patterns and surgical significance

Acta Neurochir (Wien)

Hemifacial spasm in young people treated with microvascular decompression of the facial nerve

Neurosurgery

Hemifacial spasm in childhood and adolescence

Neurosurgery

Spinal arachnoid cyst associated with arachnoiditis following subarachnoid haemorrhage in adult patients: a case report and literature review

Br J Neurosurg

Spinal arachnoiditis following subarachnoid haemorrhage: report of two cases and review of the literature

Acta Neurochir (Wien)

Is the root entry/exit zone important in microvascular compression syndromes?

Neurosurgery

A comparative study of primary and secondary hemifacial spasm

Arch Neurol

Original Article
Preliminary Study on the Relationship Between Inflammation and Hemifacial Spasm