顔面痙攣に対する微小血管減荷術後に帯状疱疹ウイルスの再活性化により遅発性顔面神経麻痺を来した1例

Delayed Facial Palsy after Microvascular Decompression for Hemifacial Spasm due to Reactivation of Varicella-zoster Virus

Ⅰ．はじめに

　顔面痙攣に対して微小血管減荷術（microvascular decompression；MVD）を行った後，遅発性に同側の顔面神経麻痺が起こることは知られているが，比較的稀であり，その原因について詳細に検討した報告は少ない．今回われわれは，微小血管減荷術後10日目に遅発性顔面神経麻痺を来し，その原因が帯状疱疹ウイルスの再活性化と考えられた症例を経験したので，若干の文献的考察を加えて報告する．

We report a patient suffering from delayed facial palsy after microvascular decompression (MVD) for hemifacial spasm, in whom the pathogenesis was proved. A 56-year-old man with a left hemifacial spasm was admitted to our hospital. Preoperative MR imaging showed that the left anterior inferior cerebellar artery (AICA) was compressing the left facial nerve. The causative vessel was defined as AICA during surgery, and MVD was performed successfully.