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Facial Motor Neuron Excitability in Hemifacial Spasm: A Facial MEP Study

Published online by Cambridge University Press:  23 September 2014

Marshall F. Wilkinson  and
Anthony M. Kaufmann
Marshall F. Wilkinson
Affiliation:
Section of Neurosurgery, Health Sciences Centre and University of Manitoba, Winnipeg, Manitoba, Canada
Anthony M. Kaufmann
Affiliation:
Section of Neurosurgery, Health Sciences Centre and University of Manitoba, Winnipeg, Manitoba, Canada
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Abstract

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Introduction:

Hemifacial spasm (HFS) may be due to peripheral axon ephapsis or central motor neuron hyperexcitability. Low facial motor evoked potential (MEP) thresholds or MEP responses to single pulse stimulation (normally multipulse stimulation is needed) may support the central hypothesis.

Methods:

We retrospectively compared response thresholds for facial MEPs in 65 patients undergoing surgical microvascular decompression (MVD) for HFS and 29 patients undergoing surgery for skull base tumors.

Results:

Single pulse stimulation elicited facial Mep in up to 87% of HFS patients whereas only 10% of tumor patients responded to single pulse stimulation. When comparing facial MEP thresholds using multi-pulse stimulus trains the voltage required in the HFS group were significantly lower then in skull base tumor patients (p < 0.001). the MEP latencies and amplitudes at threshold stimulation were similar between the two groups.

Conclusions:

these results suggest the facial corticobulbar pathway demonstrates enhanced excitability in HFS.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 2 , March 2014 , pp. 239 - 245
Copyright
Copyright © The Canadian Journal of Neurological 2014

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