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“Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign
Hemifacial spasm (HFS) is a benign condition characterized by unilateral, involuntary, paroxysmal clonic and tonic contractions of the facial muscles. This condition usually results from a focal demyelination at the root entry zone of the 7(th) cranial nerve secondary to a vascular loop compression,...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703023/ https://www.ncbi.nlm.nih.gov/pubmed/31497150 http://dx.doi.org/10.4103/ajns.AJNS_48_19 |
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author | Gosal, Jaskaran Singh Das, Kuntal Kanti Khatri, Deepak Attri, Gagandeep Jaiswal, Awadhesh Kumar |
author_facet | Gosal, Jaskaran Singh Das, Kuntal Kanti Khatri, Deepak Attri, Gagandeep Jaiswal, Awadhesh Kumar |
author_sort | Gosal, Jaskaran Singh |
collection | PubMed |
description | Hemifacial spasm (HFS) is a benign condition characterized by unilateral, involuntary, paroxysmal clonic and tonic contractions of the facial muscles. This condition usually results from a focal demyelination at the root entry zone of the 7(th) cranial nerve secondary to a vascular loop compression, and hence, it responds to microvascular decompression (MVD) surgery, similar to trigeminal neuralgia. Herein, we report an interesting clinical finding of a contralateral dry eye in the case of HFS, which has not been described previously and discuss the possible underlying mechanisms. A 53-year-old man presented with a 6-month history of involuntary twitching movements of the left hemiface that persisted during sleep, consistent with the diagnosis of HFS. The patient's attempts to voluntarily control the troublesome involuntary left-sided eye blinking led to the development of dryness and reddening of the right eye. Corneal reflex, both direct and consensual, was intact bilaterally, and an ophthalmological examination ruled out the diagnosis of conjunctivitis. The patient underwent MVD of the facial nerve. To our surprise and validating our supposition, his contralateral conjunctival hyperemia and dry eye resolved within a day of surgery, along with complete resolution of the HFS. HFS can lead to the contralateral dry eye from the voluntary suppression of ocular blinking which resolves following MVD. We demonstrate this finding for the first time and believe its recognition may be of value in the patient management. |
format | Online Article Text |
id | pubmed-6703023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-67030232019-09-06 “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign Gosal, Jaskaran Singh Das, Kuntal Kanti Khatri, Deepak Attri, Gagandeep Jaiswal, Awadhesh Kumar Asian J Neurosurg Case Report Hemifacial spasm (HFS) is a benign condition characterized by unilateral, involuntary, paroxysmal clonic and tonic contractions of the facial muscles. This condition usually results from a focal demyelination at the root entry zone of the 7(th) cranial nerve secondary to a vascular loop compression, and hence, it responds to microvascular decompression (MVD) surgery, similar to trigeminal neuralgia. Herein, we report an interesting clinical finding of a contralateral dry eye in the case of HFS, which has not been described previously and discuss the possible underlying mechanisms. A 53-year-old man presented with a 6-month history of involuntary twitching movements of the left hemiface that persisted during sleep, consistent with the diagnosis of HFS. The patient's attempts to voluntarily control the troublesome involuntary left-sided eye blinking led to the development of dryness and reddening of the right eye. Corneal reflex, both direct and consensual, was intact bilaterally, and an ophthalmological examination ruled out the diagnosis of conjunctivitis. The patient underwent MVD of the facial nerve. To our surprise and validating our supposition, his contralateral conjunctival hyperemia and dry eye resolved within a day of surgery, along with complete resolution of the HFS. HFS can lead to the contralateral dry eye from the voluntary suppression of ocular blinking which resolves following MVD. We demonstrate this finding for the first time and believe its recognition may be of value in the patient management. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6703023/ /pubmed/31497150 http://dx.doi.org/10.4103/ajns.AJNS_48_19 Text en Copyright: © 2019 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Gosal, Jaskaran Singh Das, Kuntal Kanti Khatri, Deepak Attri, Gagandeep Jaiswal, Awadhesh Kumar “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign |
title | “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign |
title_full | “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign |
title_fullStr | “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign |
title_full_unstemmed | “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign |
title_short | “Contralateral Dry Eye in Hemifacial Spasm:” A New Clinical Sign |
title_sort | “contralateral dry eye in hemifacial spasm:” a new clinical sign |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703023/ https://www.ncbi.nlm.nih.gov/pubmed/31497150 http://dx.doi.org/10.4103/ajns.AJNS_48_19 |
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