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Facial Nerve Schwannoma

      Re: Facial Nerve Schwannoma

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Posted by CCF Neurology MD on February 06, 1998 at 12:42:23:

In Reply to: Facial Nerve Schwannoma posted by AB on February 04, 1998 at 10:32:45:

: My friend was diagnosed to have a facial nerve schwannoma 1/2 year ago (left side - about 1 mm, the size didn't change since our last MRI).  My friend is experiencing twitching on the left side of the face.  The twitching sometimes is felt on the left eyebrow, upper left lip, and the left jaw.  Sometimes the twitching is felt on the right side also.  These twitching happen intermmitenly.  My questions are:  1)  Are the twitching cause by the schwannoma? (Our doctor said that it MIGHT be caused by the schwannoma.  He did not have a definitive answer to this question.)  2)  If the twitching does caused by the schannoma, then is there a possibility that the twitching will be permanent (if the twitching will happen all the time) in the future?  3)  What are the initial "standard" symptom(s) that we can expect to have in the future?  4)  How many facial nerve schwannoma patients does your hospital treat?
=Dear AB, what you are describing is a hemifacial spasm secondary to a possible compression of the facial nerve by the schwann oma.  Eventually, the entire face can be affected from the forehead to the neck.  Furthermore, the twitching of the face can become continous and be aggravated by voluntary and reflexive movements of the face.  Treatment of this condition is either non-surgical or surgical.  If you wish to pursue  a non-surgical course, I would recommend an evaluation by a movement disorder specialist (At CCF, Dept. of  Neurology, R. Stanley Burns) for verification of the diagnosis and treatment options.  Patients with similar diagnosis have been treated with and responded to Anti-epilleptic drugs (tegretol or neurontin) and/or to anti-spasmodic agents (baclofen ) in the past.  Other patients have had good success with botulinum toxin  injections directly into the muscles innervated by the facial nerve.  Surgery may be necessary, however, if the scwannoma continues to grow in size and causes  further compression of the facial nerve to the point that the nerve is damaged and facial weakness ensues or you do not respond to the medical treatment and the symptons are affecting you in both social and professional settings.  I would therefore recommend you to see a Neurosurgeon (At CCF Departemnt of Neurosurgery,Dr. J. Lee) who specializes in post-fossa surgeries which includes the facial nerve schwannoma.  He may advise you on your options including whether surgery or perhaps radiation is the best treatment choice.  If surgery is the only option, then the number performed, plus risks and success rate,  can be addrressed by the neurosurgeon at that time.  "This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition."                      

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