Rudzińska Monika, Wójcik-Pędziwiatr Magdalena, Malec Michalina, Grabska Natalia, Hartel Marcin, Szczudlik Andrzej
Department of Neurology, Medical University of Silesia, Katowice, Poland; Department of Neurology, Jagiellonian University Medical College, Kraków, Poland.
Department of Neurology with Unit of Stroke and Unit of Neurological Rehabilitation, Hospital John Paul II, Kraków, Poland; Department of Neurology, Jagiellonian University Medical College, Kraków, Poland.
Neurol Neurochir Pol. 2014;48(6):383-6. doi: 10.1016/j.pjnns.2014.09.006. Epub 2014 Oct 8.
So far, there are only two studies evaluating the relation between the small volume of the posterior cranial fossa (VPCF) and the occurrence of HFS, both on Asian population. The aim of the study was to determine small VPCF and arterial hypertension (AH), as risk factors for hemifacial spasm (HFS) and their relation to neurovascular conflict (NVC) in Polish Caucasian-origin patients.
The study included 60 patients with idiopathic HFS and 60 healthy volunteers matched by sex and age. AH was defined according to WHO. The VPCF measured the volume of the prepontine, prespinal and both cerebellopontine angle cisterns in MRI scans.
There were no significant differences between occurrence of AH and the VPCF of patients and controls but the mean VPCF in women was significantly smaller than in men, In the multivariate regression analysis model only NVC was the statistically significant. In the subgroup of >50-year-old patients the most dominant risk factor was NVC (OR 71.09; 95% CI 21.08-239.77; p=0.0000), followed by the AH duration (OR 1.07; 95% CI 1.00-1.16; p=0.047). In the subgroup of <50 years, NVC was also the dominant risk factor, followed by the lower VPCF (Walad test: OR 0.4; 95% CI 0.16-1.04; p=0.045).
There was no significant difference in VPCF and in frequency of AH diagnosis in HFS patients and age- and sex-related controls, but the logistic regression analysis showed that small VPCF and AH duration are risk factors of HFS in younger and older patients respectively.
到目前为止，仅有两项针对亚洲人群的研究评估了后颅窝容积小（VPCF）与面肌痉挛（HFS）发生之间的关系。本研究的目的是确定波兰白种人后裔患者中，小VPCF和动脉高血压（AH）作为面肌痉挛（HFS）的危险因素及其与神经血管冲突（NVC）的关系。
本研究纳入了60例特发性HFS患者和60名年龄和性别匹配的健康志愿者。AH根据世界卫生组织的标准定义。VPCF通过MRI扫描测量脑桥前、脊髓前以及双侧小脑脑桥角池的容积。
患者和对照组的AH发生率及VPCF之间无显著差异，但女性的平均VPCF显著小于男性。在多因素回归分析模型中，只有NVC具有统计学意义。在年龄大于50岁的患者亚组中，最主要的危险因素是NVC（比值比71.09；95%可信区间21.08 - 239.77；p = 0.0000），其次是AH病程（比值比1.07；95%可信区间1.00 - 1.16；p = 0.047）。在年龄小于50岁的亚组中，NVC也是主要危险因素，其次是较低的VPCF（瓦尔德检验：比值比0.4；95%可信区间0.16 - 1.04；p = 0.045）。
HFS患者与年龄和性别匹配的对照组在VPCF及AH诊断频率方面无显著差异，但逻辑回归分析表明，小VPCF和AH病程分别是年轻和老年患者HFS的危险因素。
