Mohinish Bhatjiwale1, Mrudul Bhatjiwale2,3. 1. M.Ch (Neurosurgery), Craniofacial Pain & Neuro Health Foundation Clinic, Borivali, & Manav Kalyan Kendra, Dahisar, Mumbai, India. 2. D.N.B. (Neurosurgery) Resident, Department of Neurosurgery, Narayana Hrudayalaya, Bengaluru, India. mbhatjiwale@gmail.com. 3. The Craniofacial Pain & Neuro Health Foundation Clinic, 006, D-31, Yogi Nagar, Borivali West, Mumbai, 400091, India. mbhatjiwale@gmail.com.
Abstract
BACKGROUND: Facial palsy and migraine have frequently been reported to occur in conjunction. We report a case series and propound a theory to explain the same. AIMS AND OBJECTIVES: To postulate an anatomico-pathophysiological association in the causative factor of lower motor neuron type of facial palsy in cases with migraine without aura. MATERIALS AND METHODS: Preliminary experiences and observations in 12 cases suffering from facial palsy following an attack of migraine without aura, mainly in the occipital and posterior auricular region, are elaborated. RESULTS: Facial palsy occurred on the ipsilateral side as the headaches in a majority of the cases (83.33%) and in rare cases of bilateral headaches (16.67%), it lateralised to the side the headaches were more severe. In most of these cases (75%), a complete clinical recovery was noted within 6 months. CONCLUSION: We concluded that neurogenic inflammation of the facial nerve trunk caused by its proximity to the dilated posterior auricular/stylomastoid/occipital and superficial temporal arteries during a migraine attack leads to a temporary lower motor neuron type of paresis of the muscles supplied by the facial nerve. SIGNIFICANCE: This pathophysiological understanding of the disease mechanism could open new avenues as to the treatment of this condition. This proposition indicates in clearer light than before, a possible mechanism to explain the higher incidence and risk of facial palsy in migraineurs.
BACKGROUND:Facial palsy and migraine have frequently been reported to occur in conjunction. We report a case series and propound a theory to explain the same. AIMS AND OBJECTIVES: To postulate an anatomico-pathophysiological association in the causative factor of lower motor neuron type of facial palsy in cases with migraine without aura. MATERIALS AND METHODS: Preliminary experiences and observations in 12 cases suffering from facial palsy following an attack of migraine without aura, mainly in the occipital and posterior auricular region, are elaborated. RESULTS:Facial palsy occurred on the ipsilateral side as the headaches in a majority of the cases (83.33%) and in rare cases of bilateral headaches (16.67%), it lateralised to the side the headaches were more severe. In most of these cases (75%), a complete clinical recovery was noted within 6 months. CONCLUSION: We concluded that neurogenic inflammation of the facial nerve trunk caused by its proximity to the dilated posterior auricular/stylomastoid/occipital and superficial temporal arteries during a migraine attack leads to a temporary lower motor neuron type of paresis of the muscles supplied by the facial nerve. SIGNIFICANCE: This pathophysiological understanding of the disease mechanism could open new avenues as to the treatment of this condition. This proposition indicates in clearer light than before, a possible mechanism to explain the higher incidence and risk of facial palsy in migraineurs.
Authors: Mohammad S Asghar; Adam E Hansen; Faisal M Amin; R J van der Geest; Patrick van der Koning; Henrik B W Larsson; Jes Olesen; Messoud Ashina Journal: Ann Neurol Date: 2011-03-17 Impact factor: 10.422
Authors: Frank M Sullivan; Iain R C Swan; Peter T Donnan; Jillian M Morrison; Blair H Smith; Brian McKinstry; Richard J Davenport; Luke D Vale; Janet E Clarkson; Victoria Hammersley; Sima Hayavi; Anne McAteer; Ken Stewart; Fergus Daly Journal: N Engl J Med Date: 2007-10-18 Impact factor: 91.245
Authors: I Jansen; R Uddman; M Hocherman; R Ekman; K Jensen; J Olesen; P Stiernholm; L Edvinsson Journal: Ann Neurol Date: 1986-10 Impact factor: 10.422