Delayed Resolution of Residual Hemifacial Spasm after Microvascular Decompression Operations

Ishikawa, Mami; Nakanishi, Tōru; Takamiya, Yoshiaki; Namiki, Jun

doi:10.1097/00006123-200110000-00013

Cited by 25 publications

(31 citation statements)

References 20 publications

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“…We repetitively found late effect of MVD amongst our patients. Ishiakawa et al [30] were the first to describe the postoperative course in detail after MVD. In their study, approximately 50% of all patients who underwent MVD had some degree of postoperative HFS.…”

Section: Discussionmentioning

confidence: 99%

Microvascular decompression for hemifacial spasm: postoperative neurologic follow‐up and evaluation of life quality

Heuser

Kerty

Eide

et al. 2007

Euro J of Neurology

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Microvascular decompression (MVD) is an effective and safe treatment in hemifacial spasm (HFS). Postoperative evaluations are usually made by neurosurgeons. Follow-up studies performed by neurologists and postoperative quality of life (QoL) investigations are lacking. All 25 HFS patients operated with MVD in our centre between 2000 and 2004 were evaluated with the recently validated HFS-7 scheme, extended with the item 'sleep disturbance due to HFS' (HFS-8). The patients underwent a careful neurological examination median 3 years after the operation. The evaluation focused on clinical aspects, changes in blood pressure and time until observable effect of MVD. The evaluation of HFS-7 questionnaire and the extended form (HFS-8) showed significant improvement in QoL after MVD. Neurological outcome was in almost all cases excellent or good. Eleven (44%) patients had no neurological deficits at all. Only one patient had serious complications with ipsilateral facial palsy, deafness, balance problems and vertigo. The other patients had minor neurological findings or symptoms. Eighteen (72%) patients experienced early effect within 3 months after MVD; seven (28%) patients had late effect between 6 and 14 months. Median age of the patients with late effect (62.6 years) was significantly higher than in those with early effect (52.7 years).

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Section: Discussionmentioning

confidence: 99%

Microvascular decompression for hemifacial spasm: postoperative neurologic follow‐up and evaluation of life quality

Heuser

Kerty

Eide

et al. 2007

Euro J of Neurology

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“…Ishikawa et al reported that 90% of patients with residual post-operative spasm had resolution of their symptoms within 8 months. 15 In addition, Gotu et al described immediate cure following MVD in 76.5% of cases, and a 91.6% cure rate at 1 year. 16 Shin et al achieved an ''excellent'' result in 61.1% of patients 1 week after MVD, and in 82.7% of patients 6 months after MVD.…”

Section: Discussionmentioning

confidence: 99%

Repeat microvascular decompression for hemifacial spasm

Horowitz²,

Burkhart³

et al. 2005

Journal of Neurology, Neurosurgery & Psychiatry

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Objective: To report our experience with repeat microvascular decompression (MVD) for hemifacial spasm (HFS) in patients who have failed their first operation. Methods: The authors describe 41 redo MVDs for HFS in 36 patients performed over a 3 year period. Seven patients underwent early re-operation after an aborted seventh nerve decompression. Eight patients underwent early re-operation for clinical failure. Eighteen patients underwent late re-operation for spasm recurrence long after their original MVD. Eight MVDs were performed on patients who had already undergone at least two prior operations. Results: Twenty four patients experienced complete spasm resolution (70.6%), eight patients had near total resolution (23.5%), and two patients failed re-operation (5.9%). Two patients were lost to follow up (5.6%). A favourable outcome was reported by 82.4% of patients at a mean follow up interval of 18 months. A total of 91.7% of patients 50 years of age or younger were cured at follow up versus 59.1% of patients older than 50 (p = 0.04). Patients undergoing early re-operation were significantly more likely to be cured or improved than patients undergoing late re-operation (p = 0.03). Conclusions: Repeat MVD for HFS is effective in experienced hands. Younger patients respond better to repeat MVD. Late repeat MVD for HFS is a reasonable treatment option, although results are less favourable than for early re-operation.

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“…At this time point, HFS was abolished in five patients in whom LSRs persisted at the end of surgery. However, HFS can recur or disappear several months after MVD,27 28 and so the immediate postoperative result does not always reflect the long-term outcome. Actually, we found that the absence of LSRs at the end of surgery correlated to MVD efficacy in the long term.…”

Section: Discussionmentioning

confidence: 99%

A reappraisal of the value of lateral spread response monitoring in the treatment of hemifacial spasm by microvascular decompression

Neves

Lefaucheur

Andrade

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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Delayed Resolution of Residual Hemifacial Spasm after Microvascular Decompression Operations

Abstract: Approximately 50% of patients with HFS exhibited residual spasm postoperatively. An immediate postoperative silent period of 4 days without spasm was characteristic. One-quarter, one-half, and 90% of the residual spasm resolved by 1 week, 1 month, and 8 months after surgery, respectively.

Cited by 25 publications

References 20 publications

Microvascular decompression for hemifacial spasm: postoperative neurologic follow‐up and evaluation of life quality

Microvascular decompression for hemifacial spasm: postoperative neurologic follow‐up and evaluation of life quality

Repeat microvascular decompression for hemifacial spasm

A reappraisal of the value of lateral spread response monitoring in the treatment of hemifacial spasm by microvascular decompression

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