1/9. Painful tic convulsif caused by a brain tumor: case report and review of the literature.Patient with painful tic convulsif caused by a brain tumor is presented. The patient was admitted with right trigeminal neuralgia and ipsilateral facial spasm, i.e., painful tic convulsif. Preoperative computed tomography scans showed no apparent abnormalities; however, surgery revealed that these symptoms were associated with a pearly tumor located in the cerebellopontine angle. Subtotal resection for the decompression of the right trigeminal and facial nerves was performed and resulted in complete relief of the symptoms. Histological examination demonstrated the tumor to be an epidermoid cyst.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/9. facial nerve stimulation with cochlear implantation. VA Cooperative Study Group on cochlear implantation.The course of the facial nerve may place it within the current field generated by an activated cochlear implant to produce incidental facial movement. We investigated the presence of facial nerve stimulation associated with cochlear implants in the VA Cooperative Study of Advanced cochlear implants. Twelve of 82 patients enrolled in this study demonstrated facial nerve stimulation within 2 years of implant activation. facial nerve stimulation in six patients with multiple channel implants (Nucleus or ineraid devices) either resolved spontaneously (n = 2), or was eliminated by deactivating basal (n = 2) or apical (n = 2) electrodes. Two of six patients with single-channel electrodes (3-M/Vienna devices) demonstrated facial nerve stimulation that resolved spontaneously (n = 2), resolved with lowering current output (n = 2), or was refractory to processor adjustment (n = 2). Intraoperative assessment in one of the refractory cases indicated that facial nerve stimulation resulted from current spread through the modiolus to activate the facial nerve. A variety of factors, including implant design, stimulus parameters, and local tissue impedances, may interact to produce incidental facial stimulation. Low-impedance pathways between the scala tympani and the modiolus may deserve increased recognition as an interactive factor in cochlear implant performance.- - - - - - - - - - ranking = 11keywords = nerve (Clic here for more details about this article) |
3/9. Motor tics of the head and neck: surgical approaches and their complications.Motor tics of the head and neck, especially hemifacial spasm and spastic torticollis, are the substance of this paper. Forty-six cases are presented, and surgical techniques are described. In hemifacial spasm the intracranial neurovascular lysis of Jannetta is a valid operation with the best results to date but has a 7 1/2% risk of unilateral deafness. The extracranial submastoid partial section of Scoville is completely safe and gives excellent results, but there is a probability of mild to moderate return of the spasm in one to two year's time. In spastic torticollis the accepted radical operation consists of bilateral anterior rhizotomy of the upper three roots plus bilateral spinal accessory nerve section in the neck. A tragic complication of this operation has recently been observed by ourselves, Sweet, and Hamlin. This complication is bilateral infarction of the medulla (bilateral Wallenberg's syndrome). This has also been reported as occurring following chiropractic manipulations. For this reason the writer does limited unilateral sectioning of the spinal accessory nerve in the neck and resection of the upper third of the sternomastoid muscle, as a first stage procedure, in those cases in which rotation of the neck is the principal symptom, before doing the radical operation. Safeguards to prevent this complication include preoperative vertebral arteriography and preservation of both motor and sensory radicular arteries under magnification and maintenance of adequate neck support during the early postoperative days.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
4/9. hemifacial spasm due to aneurysmal compression of the facial nerve.hemifacial spasm developed in a woman as the only symptom of an aneurysm of the posterior inferior cerebellar artery. Using microdissecting techniques, the aneurysm was clipped and moved from its distorting position at the brain stem exit zone of the seventh nerve. After surgery, she experienced immediate relief of her facial spasm of six years' duration. This case supports the finding that hemifacial spasm may be caused by vascular lesions of the seventh nerve at the brain stem junction. Recent surgical experience indicates that the majority of the hemifacial spasm cases may be due to normal but ectatic blood vessels that cross-compress the most proximal portion of the seventh nerve. Relief may be affected without facial paralysis by a retromastoid microvascular decompressive procedure.- - - - - - - - - - ranking = 7keywords = nerve (Clic here for more details about this article) |
5/9. The newer microsurgical techniques in neurosurgery.The application of microsurgical techniques to neurological surgery has changed the treatment of several important neurological and neurosurgical diseases. Microsurgical decompression of the 5th and 7th nerves for trigeminal neuralgia and hemifacial spasm has become established as an accepted and effective technique. Application of the newer microvascular techniques in neurological surgery has increased the number of patients for whom surgical correction is possible and has, additionally, revolutionized the treatment of giant intracerebral aneurysms.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/9. forelimb tic in a horse.An 18-month-old male Quarter Horse was referred for evaluation of a tic that had started after injury to the right forelimb 4 weeks earlier. The right forelimb appeared paretic and had constant regular twitches of variable intensity that were usually sufficiently forceful to move the trunk, neck, and head. The horse frequently threw the limb forward. The twitch persisted during sleep but disappeared during general anesthesia and following sedation with xylazine. It was unaffected by acetylpromazine, diphenylhydantoin, diazepam, carbamazepine, trimethadione, procainamide, quinidine, propranolol, dantrolene, methocarbamol, dimethyl sulfoxide mixed with xylocaine, or by low volar nerve anesthesia. It remained unchanged during 21 days of hospitalization but had stopped 10 weeks after discharge. Electromyographic tracings of the limb and neck and radiographs of the cervical and proximal thoracic spine, scapulohumeral joints, and adjacent ribs were normal. A localized spinal cord lesion or peripheral neuropathy and neuralgia secondary to trauma were suspected.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
7/9. Tentorial meningioma and painful tic convulsif. Case report.A case is presented of painful tic convulsif caused by a posterior fossa meningioma, with right trigeminal neuralgia and ipsilateral hemifacial spasm. Magnetic resonance images showed an ectatic right vertebral artery as a signal-void area in the right cerebellopontine angle. At operation the tentorial meningioma, which did not compress either the fifth or the seventh cranial nerves directly, was totally removed via a suboccipital craniectomy. The patient had complete postoperative relief from the trigeminal neuralgia and her hemifacial spasm improved markedly with decreased frequency. From a pathophysiological standpoint, the painful tic convulsif in this case was probably produced by the tumor compressing and displacing the brainstem directly, with secondary neurovascular compression of the fifth and seventh nerves (the so-called "remote effect").- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
8/9. Painful tic convulsif.Painful tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs primarily in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery--less frequently an arteriovenous malformation or cholesteatoma--which compresses the trigeminal and facial nerve roots in the posterior fossa. In rare instances this syndrome may be caused by disseminated sclerosis. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography and vertebrobasilar angiography should be performed in every case.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
9/9. Hypothenar Dimpling. A peripheral equivalent of hemifacial spasm?In two patients, the skin over both hypothenar eminences underwent intermittent, spontaneous, irregular, dimpling contractions. The dimpling was benign, and was the result of spontaneous discharge of motor units in the palmaris brevis muscle. Electrophysiological investigations localized the site of origin of the discharge to the ulnar nerve, possibly at the wrist, but there was no clinical or physiological evidence of neuropathy or of nerve compression. In many respects, the clinical and electrophysiological features of hypothenar dimpling resemble hemifacial spasm.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |