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Annales de Dermatologie et de Vénéréologie
Volume 136, n° S4
pages 142-145 (mai 2009)
Doi : 10.1016/S0151-9638(09)74542-9
Le spasme hémifacial
Hemifacial spasm

P. Krystkowiak
Service de neurologie, CNRS UMR 8160, CHU d’Amiens, 80054 Amiens cedex 


Le spasme hémifacial est, avec le blépharospasme, une des deux pathologies du mouvement les plus fréquentes impliquant la sphère crânienne. Il est caractérisé par des contractions involontaires et unilatérales des muscles impliqués dans la mimique faciale, muscles innervés par le nerf facial. Le plus souvent, le spasme hémifacial est un mouvement anormal involontaire périphérique résultant d’un conflit entre un vaisseau artériel et le nerf facial au niveau de l’angle ponto-cérébelleux à son émergence du tronc cérébral. Bien qu’il s’agisse d’une pathologie bénigne, le spasme hémifacial peut être responsable d’un handicap fonctionnel et esthétique. Il s’agit d’une pathologie d’évolution chronique et les rémissions spontanées sont exceptionnelles. Les deux traitements les plus efficaces et facilement accessibles sont la chirurgie (décompression microvasculaire du nerf facial) et les injections de toxine botulique au niveau de la musculature faciale.

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Hemifacial spasm is one of the two most common craniofacial movement disorders (blepharospasm is the second one). It is characterised by unilateral involuntary contractions of muscles involved in facial expression that are innervated by the facial nerve. Most of the time, hemifacial spasm is a peripherally-induced movement disorder caused by vascular compression of the facial nerve near its origin from the brainstem. Although it is a benign condition, it can cause significant cosmetic and functional disability. It is a chronic disease and spontaneous recovery is very rare. The two treatments that are really efficient and routinely available are microvascular decompression and botulinum toxin muscular injections.

The full text of this article is available in PDF format.

Mots clés : Spasme hémifacial, Toxine botulique, Décompression microvasculaire

Keywords : Hemifacial spasm, Botulinum toxin, Microvascular decompression

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