Recordings from the facial nucleus in the rat : signs of abnormal facial muscle response

On the basis of results of electrophysiological studies in patients undergoing microvascular decompression (MVD) operations to relieve hemifacial spasm (HFS), we have postulated that the abnormal muscle response characteristically found in patients with HFS is the result of irritation of the facial nerve by the blood vessel that is compressing the facial nerve near its exit from the brainstem in these patients. This abnormal muscle response is seen when one branch of the facial nerve is electrically stimulated and recordings are made from muscles that are innervated by other branches of the facial nerve. We further hypothesized that the facial nucleus is hyperactive in patients with HFS and that the spasm and the abnormal muscle response are results of a phenomenon known as "kindling". These hypotheses are supported by recent studies showing that chronic electrical stimulation of the facial nerve trunk in rats near the brainstem results in an abnormal muscle response that is similar to that seen in patients with HFS. In this paper, we present the results of recording from the facial motonucleus in rats that had been subjected to repeated electrical stimulation of the facial nerve. The results indicate that the abnormal muscle response in these rats was caused by changes in the function of the facial motonucleus. We interpret these results as showing that the physiological abnormalities that give rise to the signs of HFS in man are located in the facial motonucleus, and that the changes in the function of the nucleus are produced by chronic antidromic neutral activity resulting from close contact between a blood vessel and the facial nerve.