Zusammenfassung
Verkrampfungen im Gesichts- und Mundbereich stellen häufig eine differenzialdiagnostische
Herausforderung dar. Eine seltene Ursache ist der Spasmus hemilingualis bei dem es
analog zum Spasmus hemifacialis – mit Betroffenheit des Nervus facialis – zu einer
Kompression des Nervus hypoglossus kommt. In unserer Kasuistik berichten wir über
einen Patienten mit Spasmus hemilingualis bei welchen ein Kontakt des Nervus hypoglossus
durch die Arteria vertebralis und die Arteria cerebelli posterior inferior nachgewiesen
werden konnte. An Therapieoptionen stehen wie beim Spasmus hemifacialis die Behandlung
mit Antikonvulsiva (Carbamazepin, Pregabalin, Gabapentin), Botulinumtoxin und die
dekomprimierende Operation zur Auswahl. Unser Patient konnte durch das Kauen von Kaugummi
seine Beschwerden lindern. Mögliche pathophysiologische Mechanismen hierzu werden
diskutiert.
Abstract
Spasms in the face or mouth are often a challenge for neurologists. A rare cause is
hemilingual spasm. In analogy to the hemifacial spasm in which the facial nerve is
involved, the hypoglossus nerve is compressed. We report on a patient with hemilingual
spasm in whom dislocation of the hypoglossus nerve by the vertebral artery and the
cerebellar posterior inferior artery was found. Treatment options are the same as
for hemifacial spasm (e. g., carbamazepine, pregabaline, gabapentin, botulinum toxin
or decompression surgery). Our patient was able to control the symptoms by chewing.
Possible pathophysiological concepts are discussed.
Schlüsselwörter
Spasmus hemilingualis - Nervus hypoglossus - Arteria vertebralis
Keywords
hemilingual spasm - hypoglossal nerve - vertebral artery
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Dr. David Czell
Brauerstr. 15
8400 Winterthur, Schweiz
Email: david.czell@gmx.ch
