Successful treatment of hemifacial spasm with selective facial nerve block using doxorubicin (adriamycin) under local anesthesia.

Abstract

OBJECTIVE:

To describe our experience with selective chemical rhizotomy of facial nerves using adriamycin (ADM) in a patient with hemifacial spasm (HFS). This unique technique is less invasive than intracranial neurosurgery and enables one to perform a permanent nerve block under local anesthesia.

PATIENT:

The patient, a 73-year-old female, had difficulty opening her left eye. Following unsuccessful treatment with anti-epileptic medicine, she received selective intraneural injections of ADM under local anesthesia. One week after the surgery the spasms had disappeared completely. No major complications were caused by this procedure and there had been no recurrence of spasms 3 years after the surgery.

RESULTS:

It is thought that recurrence of HFS should be observed after simple neurotomy due to regrowth of nerve fibers. However, this did not occur after chemical rhizotomy with ADM. This method clearly differs from previously used varieties of simple neurotomy because the latter technique does not cause severe destructive changes in the facial motor nucleus.

CONCLUSION:

Selective facial nerve chemical rhizotomy with ADM under local anesthesia may be effective in treating a subgroup of patients with HFS, especially elderly patients and those in the high-risk group for general anesthesia and intracranial neurosurgery.

• Authors: Makoto Ito, Mitsuhiro Hasegawa, Sigeru Hoshida, Takaki Miwa, Mitsuru Furukawa
• Journal: Acta oto-laryngologica (Acta Otolaryngol) Vol. 124 Issue 2 Pg. 217-20 (Mar 2004) ISSN: 0001-6489 [Print] England
• PMID: 15072429 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibiotics, Antineoplastic
• Doxorubicin

Topics

• Aged
• Anesthesia, Local
• Antibiotics, Antineoplastic (administration & dosage, pharmacology, therapeutic use)
• Cheek (innervation)
• Doxorubicin (administration & dosage, pharmacology, therapeutic use)
• Facial Muscles (innervation, physiology)
• Facial Nerve (drug effects)
• Female
• Hemifacial Spasm (drug therapy, physiopathology)
• Humans
• Injections (methods)
• Nerve Block
• Treatment Outcome
• Zygoma (innervation)