| Hemifacial Spasm Recurrence after Microvascular Decompression : Is it a Failure or Delayed Cure? |
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Yu Seok Lim, Seung Hwan Lee, Hee Sup Shin, Jun Seok Koh |
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Stroke and Neurological Disorders Centre, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea |
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| Abstract |
Background
and Purpose: Even though microvascular decompression (MVD) is the standard treatment for hemifacial spasm
(HFS), the treatment result does not reach 100% yet. There are some patients who experience residual HFS or re-appearance
of HFS following temporary relief after surgery. In these instances, the physicians could encounter the moment to judge whether
to wait or perform additional treatment. Herein, we analyzed our data for elucidating the reason and prognosis in HFS re-appearance.
Patients and Methods: We retrospectively reviewed data from 43 patients meeting our inclusion criteria who underwent MVD
for HFS from November, 2006, to February, 2013. The patients are divided into three groups : group A, the patients whose symptoms of spasm were completely disappeared immediately after surgery but recurred within 14 days ; group B, the patients whose
symptoms of spasm were persisted after surgery ; group C, the patients whose symptoms of spasm completely disappeared and
did not recurred. We analyzed patient characteristics, duration of symptoms, imaging findings, surgical findings, complications
and outcomes.
Results
The surgical results showed “spasm free” in 37 (86.0%) patients, “improved” in 4 (9.3%) patients, and “failed” in 2 (4.6%)
patients at the time of last follow-up. Fourteen patients (32.5%) were experienced re-appearing of HFS within 14 days after surgery (group A). Seven patients (16.2%) had remained HFS after surgery (group B), and 22 patients (51.1%) showed complete
disappearance of HFS immediately after surgery (group C). Among group A patients, the re-appearing HFS disappeared gradually over several weeks in 11 patients (78.5% of 14 patients). Two patients had minimal symptom of HFS but 1 had no improvement of HFS.
Conclusions
After MVD for HFS, some patients experienced transients HFS recurrence during postoperative course despite
sufficient decompression of offending vessel from facial nerve REZ. However, most of recurred HFS resolved gradually over a
period of time. |
| Key Words:
Hemifacial spasm, Microvascular decompression, Recurrence. |
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