Wilkins R H
South Med J. 1981 Dec;74(12):1471-4.
Hemifacial spasm is a syndrome of intermittent and tonic unilateral facial muscular contraction; mild facial weakness on the same side is also frequently present. Hemifacial spasm can be differentiated clinically from habit spasms, blepharospasm, facial synkinesis following Bell's palsy, facial myokymia, and masticatory spasm. The syndrome of hemifacial spasm is caused by a variety of lesions; the common feature appears to be compression of the facial nerve at the pons. Diagnostic studies do not usually add significant information to that gained from the history and physical examination. The best current treatment (aside from removing an etiologic lesion such as a posterior fossa tumor in the small percentage of cases with such lesions) is microvascular decompression of the facial nerve at the pons through a retromastoid craniectomy. Of 30 patients treated in this manner, 28 have been satisfied with the results. On the most recent follow-up examination, 16 had no hemifacial spasm, nine had only slight periodic twitching about the eye, and three had occasional mild episodes of hemifacial spasm.
面肌痉挛是一种单侧面部肌肉间歇性和强直性收缩的综合征；同侧轻度面部无力也很常见。面肌痉挛在临床上可与习惯性痉挛、眼睑痉挛、贝尔面瘫后的面部联带运动、面部肌纤维颤搐和咀嚼肌痉挛相鉴别。面肌痉挛综合征由多种病变引起；其共同特征似乎是面神经在脑桥处受压。诊断性检查通常不会为从病史和体格检查中获得的信息增加显著内容。目前最好的治疗方法（除了在少数有病因性病变的病例中切除病因性病变，如后颅窝肿瘤）是通过乳突后颅骨切除术对脑桥处的面神经进行微血管减压。用这种方法治疗的30例患者中，28例对结果满意。在最近的随访检查中，16例没有面肌痉挛，9例仅眼部周围有轻微的周期性抽搐，3例偶尔有轻度面肌痉挛发作。
