Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Time Course of Symptom Disappearance after Microvascular Decompression for Hemifacial Spasm

  • Oh, Eun-Tak (Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine) ;
  • Kim, Eun-Young (Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine) ;
  • Hyun, Dong-Keun (Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine) ;
  • Yoon, Seung-Hwan (Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine) ;
  • Park, Hyeon-Seon (Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine) ;
  • Park, Hyung-Chun (Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine)
  • Published : 2008.10.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : This study is to investigate time course of symptom disappearance in patients whose spasm relieved completely after microvascular decompression (MVD). Methods : Of 115 patients with hemifacial spasm (HFS) who underwent MVD from April 2003 to December 2006, 89 patients who had no facial paralysis after operation and showed no spasm at last follow-up more than 1.5 years after operation were selected. Symptom disappearance with time after MVD was classified into type 1 (symptom disappearance right after operation), type 2 (delayed symptom disappearance) and type 3 (unusual symptom disappearance). Type 2 was classified into type 2a (with postoperative silent period) and type 2b (without silent period). Results : Type 1, type 2a, type 2b and type 3 were 38.2%, 48.37%, 124% and 1.1%, respectively. Delayed disappearance group (type 2) was 60.7%. Post-operative symptom duration in all cases ranged from 0 to 900 days, average was 74.6 days and median was 14 days. In case of type 2, average post-operative symptom duration was 115.1 days and median was 42 days. Five and 3 patients required more than 1 year and 2 years, respectively, until complete disappearance of spasm. In type 2a, postoperative silent period ranged from 1 to 10 days, with an average of 24 days. Conclusion : Surgeons should be aware that delayed symptom disappearance after MVD for HFS is more common than it has been reported, silent period can be as long as 10 days and time course of symptom disappearance is various as well as unpredictable.

Keywords

References

  1. Adams CB : Microvascular compression : an alternative view and hypothesis. J Neurosurg 57 : 1-12, 1989
  2. Auger RG : Hemifacial spasm : clinical and electrophysiologic observations. Neurology 29 : 1261-1272, 1979 https://doi.org/10.1212/WNL.29.9_Part_1.1261
  3. Chang JW, Chang JH, Choi JY, Kim DI, Park YG, Chung SS : Role of postoperative magnetic resonance imaging after microvascular decompression of the facial nerve for the treatment of hemifacial spasm. Neurosurgery 50 : 720-725; discussion 726, 2002 https://doi.org/10.1097/00006123-200204000-00007
  4. Gardner WJ : Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19 : 947-958, 1962 https://doi.org/10.3171/jns.1962.19.11.0947
  5. Huang CI, Chen IH, Lee LS : Microvascular decompression for hemifacial spasm : analyses of operative findings and results in 310 patients. Neurosurgery 30 : 53-56; discussion 56-57, 1992 https://doi.org/10.1227/00006123-199201000-00010
  6. Ishikawa M, Nakanish T, Takamiya Y, Namiki J : Delayed resolution of residual hemifacial spasm after microvascular decompression operations. Neurosurgery 49 : 847-854; discussion 854- 856, 2001 https://doi.org/10.1097/00006123-200110000-00013
  7. Iwakuma T, Matsumoto A, Nakamura N : Hemifacial spasm : comparison of three different operative procedures in 110 patients. J Neruosurg 57 : 753-756, 1982 https://doi.org/10.3171/jns.1982.57.6.0753
  8. Jannetta PJ : Cranial rhizopathies. In : Youmans JR (ed). Neurological surgery. 3rd ed. Philadelphia : WB Saunders, 1990, pp4169- 4182
  9. Jannetta PJ : Microvascular decompression for hemifacial spasm. In : May M (ed). Facial nerve. New York : Thieme, 1986, pp499-508
  10. Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS : Etiology and definitive microsurgical treatment of hemifacial spasm : operative techniques and results in 47 patients. J Neurosurg 47 : 321-328, 1977 https://doi.org/10.3171/jns.1977.47.3.0321
  11. Kerber CW, Margolis MT, Newton TH : Tortuous vertebrobasilar system : a cause of cranial nerve signs. Neuroradiology 4 : 74-77, 1972 https://doi.org/10.1007/BF00344434
  12. Kondo A, Ishikawa J, Yamasaki Y, Konishi T : Microvascular decompression of cranial nerve, particularly of the 7th cranial nerve. Neurol Med Chir (Tokyo) 20 : 739-751, 1980 https://doi.org/10.2176/nmc.20.739
  13. Li CS : Varied patterns of postoperative course of disappearance of hemifacial spasm after microvascular decompression. Acta Neurochir (Wien) 147 : 617-620; discussion 620, 2005 https://doi.org/10.1007/s00701-005-0492-8
  14. Liu KN, Wu JM, Fairholm D : Hemifacial spasm : Treatment by posterior fossa surgery. J Formosan Med Assoc 80 : 1235-1239, 1981
  15. Moller AR : The cranial nerve vascular compression syndrome : II. A review of pathophysiology. Acta Neurochir (Wien) 113 : 24-30, 1991 https://doi.org/10.1007/BF01402110
  16. Moller AR, Jannetta PJ : Physiologic abnormalities in hemifacial spasm studied during microvascular decompression operation. Exp Neurol 93 : 584-600, 1986 https://doi.org/10.1016/0014-4886(86)90178-0
  17. Nielsen VK : Pathophysiology of hemifacial spasm : ephaptic transmission and ectopic excitation. Neurology 34 : 418-426, 1984 https://doi.org/10.1212/WNL.34.4.418
  18. Nielsen VK, Jannetta PJ : Pathophysilogic aspects of hemifacial spasm. Part III. Effect of facial nerve decompression. Neurology 36 : 891-897, 1984
  19. Shin JC, Chung UH, Kim YC, Park CI : Prospective study of microvascular decompression in hemifacial spasm. Neurosurgery 40 : 730-734; discussion 734-735, 1997 https://doi.org/10.1097/00006123-199704000-00013
  20. Wartenberg R : Hemifacial spasm, A Clinical and Pathophysiological study. New York : Oxford University Press, 1952
  21. Wilkin RH : Hemifacial spasm : a review. Surg Neurol 36 : 251-277, 1991 https://doi.org/10.1016/0090-3019(91)90087-P

Cited by

  1. Microvascular decompression after failed Gamma Knife surgery for trigeminal neuralgia: a safe and effective rescue therapy? : Clinical article vol.113, pp.1, 2008, https://doi.org/10.3171/2010.1.jns091386
  2. An analysis of failed microvascular decompression in patients with hemifacial spasm: focused on the early reoperative findings vol.152, pp.12, 2008, https://doi.org/10.1007/s00701-010-0794-3
  3. Re-operation for persistent hemifacial spasm after microvascular decompression with the aid of intraoperative monitoring of abnormal muscle response vol.152, pp.12, 2008, https://doi.org/10.1007/s00701-010-0837-9
  4. Correlation between idiopathic hemifacial spasm and the MRI characteristics of the vertebral artery vol.18, pp.4, 2008, https://doi.org/10.1016/j.jocn.2010.08.015
  5. Microvascular Decompressions in Patients With Coexistent Hemifacial Spasm and Trigeminal Neuralgia vol.68, pp.4, 2008, https://doi.org/10.1227/neu.0b013e318208f5ac
  6. Safety and effectiveness of microvascular decompression for treatment of hemifacial spasm: a systematic review vol.26, pp.4, 2012, https://doi.org/10.3109/02688697.2011.641613
  7. A significant correlation between delayed cure after microvascular decompression and positive response to preoperative anticonvulsant therapy in patients with hemifacial spasm vol.39, pp.4, 2008, https://doi.org/10.1007/s10143-016-0729-4
  8. Letter to the Editor: Failed microvascular decompression surgery vol.125, pp.1, 2016, https://doi.org/10.3171/2015.12.jns152925
  9. A multivariate analysis for delayed healing of facial muscle spasm after microvascular decompression vol.34, pp.3, 2008, https://doi.org/10.12669/pjms.343.15015