片側顔面痙攣の歴史

Historical Review of Hemifacial Spasm

Point

・片側顔面痙攣は古くからさまざまな文献に記載され，19世紀前半には顔面神経圧迫が原因になることも知られていた．

・片側顔面痙攣の症状は文学・美術作品にも表現されている．

・治療の第一選択はボツリヌス毒素療法であり，本邦でも2000年の承認以来広く用いられている．

　Facial spasm is a disorder characterized by mostly unilateral（hemifacial）involuntary facial muscle contractions, usually caused by vascular compression of the facial nerve. It has been known since ancient times and we can currently find both old medical and artistic presentations. Charles Bell has described at least one definite case（No. Ⅳ）with hemifacial spasm in his textbook published in 1830 as did the following physicians like Romberg, Hammond, Gowers, and Brissaud. Babinski coined the name hemispasme facial in 1905 and its English term “hemifacial spasm” appeared in the article by Ehni et al. in 1945. Neurovascular or microvascular decompression surgery was applied to treat this disease in the 1960s and remains a curative therapeutic procedure. Therapy with botulinum toxin appeared as a less invasive procedure in the 1980s and is currently the preferred treatment because of its high safety and efficacy. Secondary facial spasms may occur as a consequence of facial paresis or space-occupying lesion along the facial nerve pathway.