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Hemifacial Spasm: Results of Microvascular Decompression of the Facial Nerve in 54 Patients

      During the 10-year period between January 1975 and December 1984, 367 patients with hemifacial spasm were examined at our institution. Because of the severity of the spasm, 54 patients underwent surgical management that consisted of microvascular decompression of the facial nerve. Postoperatively, the hemifacial spasm was completely resolved in 44 patients (81%), but 6 of these patients had subsequent recurrence of the condition. An additional five patients (9%) experienced improvement but were not totally free of the spasm. Five patients (9%) received no benefit from the procedure. Complications occurred in 19 patients (35%) but were usually transient. The most serious complication was permanent ipsilateral hearing loss, which occurred in eight patients (15%). Thus, in general, microvascular decompression of the facial nerve effectively alleviates hemifacial spasm.
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        • Ehni G
        • Woltman HW
        Hemifacial spasm: review of one hundred and six cases.
        Arch Neurol Psychiatry. 1945; 53: 205-211
        • Maroon JC
        • Lunsford LD
        • Deeb ZL
        Hemifacial spasm due to aneurysmal compression of the facial nerve.
        Arch Neurol. 1978; 35: 545-546
        • Miyazaki S
        • Fukushima T
        CP angle epidermoid presenting as hemifacial spasm.
        No To Shinkei. 1983; 35: 951-955
        • Pierry A
        • Cameron M
        Clonic hemifacial spasm from posterior fossa arteriovenous malformation.
        J Neurol Neurosurg Psychiatry. 1979; 42: 670-672
        • Jannetta PJ
        Trigeminal neuralgia and hemifacial spasm: etiology and definitive treatment (abstract).
        Arch Neurol. 1975; 32: 353
        • Jannetta PJ
        Hemifacial spasm.
        in: Samii M Jannetta PJ The Cranial Nerves: Anatomy, Pathology, Pathophysiology, Diagnosis, Treatment. Springer-Verlag, New York1981: 484-493
        • Neagoy DR
        • Dohn DF
        Hemifacial spasm secondary to vascular compression of the facial nerve.
        Cleve Clin Q. 1974; 41: 205-214
        • Fabinyi GCA
        • Adams CBT
        Hemifacial spasm: treatment by posterior fossa surgery.
        J Neurol Neurosurg Psychiatry. 1978; 41: 829-833
        • Wilson CB
        • Yorke C
        • Prioleau G
        Microsurgical vascular decompression for trigeminal neuralgia and hemifacial spasm.
        West J Med. 1980; 132: 481-484
        • Loeser JD
        • Chen J
        Hemifacial spasm: treatment by microsurgical facial nerve decompression.
        Neurosurgery. 1983; 13: 141-146
        • Fairholm D
        • Wu J-M
        • Liu K-N
        Hemifacial spasm: results of microvascular relocation.
        Can J Neurol Sci. 1983; 10: 187-191
        • Kim P
        • Fukushima T
        Observations on synkinesis in patients with hemifacial spasm: effect of microvascular decompression and etiological considerations.
        J Neurosurg. 1984; 60: 821-827
        • Piatt Jr, JH
        • Wilkins RH
        Treatment of tic douloureux and hemifacial spasm by posterior fossa exploration: therapeutic implications of various neurovascular relationships.
        Neurosurgery. 1984; 14: 462-471
        • Auger RG
        • Piepgras DG
        • Laws Jr, ER
        • Miller RH
        Microvascular decompression of the facial nerve for hemifacial spasm: clinical and electrophysiologic observations.
        Neurology. 1981; 31: 346-350
        • Nielsen VK
        Pathophysiology of hemifacial spasm. I. Ephaptic transmission and ectopic excitation.
        Neurology. 1984; 34: 418-426
        • Nielsen VK
        Pathophysiology of hemifacial spasm. II. Lateral spread of the supraorbital nerve reflex.
        Neurology. 1984; 34: 427-431
        • Nielsen VK
        • Jannetta PJ
        Pathophysiology of hemifacial spasm. III. Effects of facial nerve decompression.
        Neurology. 1984; 34: 891-897
        • 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. 1977; 47: 321-328
        • Alexander GE
        • Hamilton III, M
        Carbamazepine for hemifacial spasm.
        Neurology. 1982; 32: 286-287
        • Sandyk R
        Baclofen in hemifacial spasm.
        Eur Neurol. 1984; 23: 163-165