Please help me, I'm about to be exposed
Yan Feng, deputy chief physician of the Department of Neurosurgery of Zhejiang University Second Hospital, recently admitted a rather mysterious patient, the 50-year-old brother A (pseudonym) wearing a pair of large sunglasses quietly entered the consultation room, after looking around for a circle of environmental safety, he closed the door and said softly: "Doctor, I am a plainclothes policeman, please help me, I am about to be exposed." ”
It turned out that Big Brother A had been working in the border defense line for a long time, and because of the needs of his work, he often disguised himself as plainclothes to visit the case. But a new situation in the past year has bothered him very much, he always can't control the blinking, this year the situation is getting more and more serious, blinking at the same time the mouth will also be accompanied by twitches, continuous tic symptoms make him very uncomfortable, especially when he works in plain clothes, unexpected tic symptoms will always attract the attention of others, so that his visit work has been greatly affected, several times is considered to be a secret sign.
Coincidentally, Uncle Ma (pseudonym), a Hui patient from Qinghai, also encountered a similar situation. Uncle Ma is a local reputable community worker who often mediates disputes and resolves conflicts for his neighbors. Since suffering from the disease of eye and facial convulsions, his work has been greatly affected, and whenever he carries out his thought work in a serious manner, frequent convulsions always come unexpectedly, instantly breaking the serious atmosphere.
More serious was the frequent blinking, which significantly affected his field of vision, and several times when driving, because his eyes could not be opened, he could not observe the vehicles behind the side, which almost led to a car accident. Uncle Ma learned through the WeChat public account of the Second Hospital of Zhejiang University that Dr. Yan Feng is good at treating diseases in this area, so he took his family to buy a plane ticket and made a special trip to Hangzhou for medical treatment.
After carefully examining the condition of Brother Zhou and Uncle Ma, Dr. Yan told them that this is a common cranial nerve disease, and through targeted minimally invasive surgery, it can be completely cured and restore normal life.
Cranial nerves
Cranial nerves are 12 pairs of left-right symmetrical nerves emitted from the brain, which innervate the sensory and activity functions of the head and face.
For example, the facial nerve that regulates facial expressions to show joy and sorrow, the olfactory nerve that innervates the sense of smell and perceives aromas, the optic nerve that controls the eyes to observe the world, the auditory nerve that listens to the wind and birds, and the glossopharyngeal nerve that tastes delicious food.
Cranial nerves form the physiological basis for people to perceive the world, taste sweet, bitter and spicy, and feel the fragrance of birds and flowers. When the structure or function of the cranial nerve is damaged, it will greatly affect people's normal life and work.
What are the common cranial nerve disorders
facial nerve
In patients with facial nerve compression, there will be frequent eyelid beats and tics at the corners of the mouth, which can cause difficulty in opening the eyes in severe cases, which seriously affects life and work.
optic nerve
In some patients with pituitary tumors, enlarged pituitary tumors often compress the adjacent optic nerve, resulting in vision loss and visual field defects.
Acoustic neuroma
Patients with acoustic neuromas have impaired function of the auditory and facial nerves, manifested by hearing loss and facial paralysis.
trigeminal nerve
When the trigeminal nerve is compressed by blood vessels, it will cause sharp pain such as facial acupuncture and electric shock, and many patients cannot eat during the day and cannot sleep at night.
Olfactory nerve, eye-moving nerve
Meningiomas located at the base of the skull often lead to dysfunction of the olfactory nerve, oculomotor nerve, loss of smell, heavy vision, strabismus, etc.
How cranial nerve disorders are treated
The treatment principle of cranial nerve disease is to relieve various compressions of the nerve and restore the normal structure and physiological function of the cranial nerve.
(1) Patients with throbbing at the corners of the eyes caused by compression of the facial nerve and difficulty in opening their eyes, apply minimally invasive techniques to migrate the blood vessels that compress the facial nerves, relieve the compression effect of the opposite nerves, and completely cure the tic symptoms;
(2) Patients with pituitary tumor compression of the optic nerve causing vision loss, the application of minimally invasive and endoscopic techniques to completely remove the pituitary tumor, fully relieve the compression of the optic nerve, and significantly improve vision;
(3) Microsurgery can restore the patient's normal hearing by removing small acoustic neuromas, and removing large acoustic neuromas can fully relieve its compression of the brainstem and posterior group cranial nerves and restore normal physiological functions;
(4) Patients with severe pain in trigeminal neuralgia, the application of minimally invasive technology to separate the compressive blood vessels from the trigeminal nerves, the middle interval to insulate the material, completely eliminate the compression stimulation effect of blood vessels on the trigeminal nerves;
(5) Patients with tumor compression nerves at the base of the skull need to undergo craniotomy to completely remove the tumor and fully relieve its compression effect on the nerve.
Spasm of the facial muscles
Dr. Yan Feng carefully examined the results of the two patients' examinations, and in their facial nerve magnetic resonance examination, it was clear that an arterial blood vessel was compressing the facial nerve, which is the root cause of their continuous twitching of the eyes and face, and this cranial nerve disease manifested by abnormal facial nerve function is called "facial muscle spasm".
How to treat facial muscle spasms
Botulinum toxin injection treatment:
Botulinum toxin has the effect of locally paralyzing the muscles, and injecting botulinum toxin into specific locations on the eyelids and face can significantly relieve eyelid jumping and face twitching.
Advantages and disadvantages: Muscle spasm after botulinum toxin injection can be completely relieved or significantly improved, and the maintenance time is about 3 months, so the interval between each injection is not more than 3 months. However, as the course of the disease is prolonged and the number of injections accumulates, the therapeutic effect gradually decreases until it is ineffective. Some patients with long-term botulinum toxin injection will have facial paralysis such as droopy eyelids and crooked corners of the mouth, as well as complications such as dry eye and exposed keratitis.
Minimally invasive surgery:
Starting from the pathological mechanism, the minimally invasive technique is applied to separate the blood vessel from the facial nerve, and the middle pad is used to isolate the material and completely eliminate the compression effect of the opposite nerve of the blood vessel.
Advantages and disadvantages: after minimally invasive treatment, patients with facial muscle spasm symptoms will be completely cured, no longer need to take drugs or inject botulinum toxin. However, surgery under general anesthesia is required, and there are risks of headache discomfort and fever infection in the short term after surgery.
Dr. Yan used equipment such as facial nerve electrophysiology monitoring to perform minimally invasive facial nerve microvascular decompression surgery.
After waking up from anesthesia at the end of the operation, they found that the eyelids and corners of the mouth twitched, and the difficulty of opening their eyes completely disappeared. The next day they began to eat normally, and got out of bed with the support of their families to walk early rehabilitation exercises. Within a few days, they were discharged from the hospital and returned to work.
Text | Neurosurgery Yan Feng
Figure | Partly from the network
Audit | Chen Guozhong, Department of Neurosurgery Zhu Junming
Editor-in-charge | Zhu Junjun