Ephaptic Transmission is the Origin of the Abnormal Muscle Response Seen in Hemifacial Spasm

Hemifacial spasm, caused by intracranial vascular compression of the facial nerve, abates promptly after microvascular decompression, as a pivotal surgical strategy (Cook and Jannetta, 1984; Jannetta, 1997). Electrophysiological studies explored the complicated circuitry of brainstem network with the facial and trigeminal nerves, considering blink reflex, axono-axonal lateral spread, and F waves or recurrent discharge at the facial nucleus. Although there is a general belief that the hyperexcitability responsible for hemifacial spasm involves the facial nerve or the nucleus (Møller and Jannetta, 1985; Møller, 1987; Ishikawa et al., 1996), currently available data still lack direct evidence to precisely locate the site of lateral spread that causes a widespread facial contraction.

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