title: Does arteriosclerosis contribute to hemifacial spasm?
abstract: BACKGROUND
  Hemifacial spasm (HFS) is caused by pulsative vascular compression of the root exit zone (REZ) of the facial nerve. However, the mechanism that causes the offending vessels to compress the REZ has not been clarified. Elongation of intracranial arteries due to arteriosclerosis is one possibility, but such arteriosclerotic changes are not observed very frequently among patients with HFS. The aim of the present study was to investigate whether arteriosclerotic changes would contribute to the pathogenesis of HFS.
  
  
  METHODS
  This study included 111 HFS patients, all of whom were Japanese. The prevalence rates of hypertension, hyperlipidemia, and diabetes mellitus were examined as risk factors of atherosclerosis, and the cardio-ankle vascular index (CAVI) was measured as an indicator of arteriosclerotic change. The severity of white matter lesions (WMLs) in HFS patients was measured by magnetic resonance imaging. These data were compared with data from healthy Japanese controls.
  
  
  RESULTS
  The prevalence rates of the risk factors for atherosclerosis in the HFS patients were not higher than those in the general Japanese population. The CAVI scores for the HFS patients were similar to, or lower than those in the healthy controls for all age groups except 60 to 69-year-old men. The severity of WMLs in the HFS patients was not significantly worse than that in the controls.
  
  
  CONCLUSIONS
  It is suggested that arteriosclerotic changes are not involved in the pathogenesis of HFS, and that vascular compression syndromes are attributable to anatomical features of the intracranial arteries and facial nerves formed during the prenatal stage.
authors.affiliation: Department of Neurosurgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan. m_johta@saitama-med.ac.jp.
authors.forename: Miki
authors.initials: M
authors.lastname: Ohta
authors.affiliation: Department of Neurosurgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Neurosurgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Terano
authors.affiliation: Department of Neurosurgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakiya
authors.affiliation: Japan Health Promotion Foundation, 1-24-4 Ebisu, Shibuya-ku, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Fujimaki
mesh_terms: D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D019569:Hemifacial Spasm / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Arteriosclerosis; Cardio-ankle vascular index; Hemifacial spasm; White matter lesions