Synkinesis in hemifacial spasm: results of recording intracranially from the facial nerve.

We show evidence that the motonucleus of the facial nerve is involved in producing the synkinesis in patients with hemifacial spasm. These results were obtained by recording from the intracranial portion of the facial nerve and from the orbicularis oculi muscle in patients operated upon for hemifacial spasm during electrical stimulation of the mandibular branch of the facial nerve. Also, the electromyographic response from the same muscle was recorded when the facial nerve was electrically stimulated at a location near the brainstem. The results show that it is unlikely that the symptoms of patients with hemifacial spasm can be explained on the basis of ephaptic transmission at the site of lesion of the facial nerve.