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Fortschr Neurol Psychiatr 2017; 85(04): 194-198
DOI: 10.1055/s-0043-104698
Skripte der Botulinumtoxin-Akademie
© Georg Thieme Verlag KG Stuttgart · New York

Therapie des Spasmus hemifacialis mit Botulinumtoxin

Therapy of Hemifacial Spasm with Botulinum Toxin
Wolfgang H. Jost
1   Neurologische Universitätsklinik, Freiburg im Br.
,
Rainer Laskawi
2   Universitätsmedizin Göttingen, Hals-Nasen-Ohrenklinik, Göttingen
,
Anja Palmowski-Wolfe
3   Universität Basel, Universitäts-Augenklinik, Basel/Schweiz
,
Peter P. Urban
4   Asklepios Klinik Barmbek, Abt. für Neurologie, Hamburg
› Author Affiliations
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Publication History

Publication Date:
24 April 2017 (online)

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Zusammenfassung

Der Spasmus hemifacialis (SHF) ist eine häufige Erkrankung, die gekennzeichnet ist durch unwillkürliche Kontraktionen der vom Nervus facialis innervierten Muskulatur einer Gesichtshälfte. Die Symptome können tonisch oder klonisch, intermittierend oder permanent auftreten. Die Diagnosestellung erfolgt klinisch. Zur Ausschlussdiagnostik sollte eine MRT des Schädels eingesetzt werden, die einen pathologischen Nerv-Gefäß-Kontakt nachweisen und alternative Ursachen ausschließen kann. Häufig ist die Symptomatik nur gering ausgeprägt, so dass keine Therapie notwendig ist. Therapie der Wahl ist die Injektion von Botulinumtoxin zur Reduktion der pathologischen Aktivität. Die Dekompressionsoperation nach Jannetta gilt als Alternative, wird jedoch von den meisten Patienten nicht in Anspruch genommen.

Abstract

Hemifacial spasm (HFS) is a frequent disorder characterized by involuntary contractions of those muscles innervated by the facialis nerve on one side of the face. The symptoms can appear as tonic or clonic, intermittent or permanent. Diagnosis is based purely on clinical observation. Differential diagnosis should rely on cranial MRI, which can demonstrate a pathological contact between the nerves and vessels and exclude alternative causation. Often, the symptoms are not marked so that therapy may not be necessary. The therapy of choice is an injection of botulinum toxin to reduce the underlying pathological activity. As an alternative, decompression operation according to Jannetta can be considered, although it is frequently rejected by patients.

 

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