Natural History of Untreated Hemifacial Spasm: A Study of 104 Consecutive Patients over 5 Years

Abstract

Background: The natural history without treatment of a large series of hemifacial spasm (HFS) patients has not been well-documented. Objective: The purpose of this study was to characterize the natural history and clinical outcome in patients with HFS. Methods: The initial visits of all 2,155 patients and the diagnosis of HFS took place between 2001 and 2010. In 1,775 of the patients, compressing vessels were identified on magnetic resonance imaging. Of these, we excluded 1,469 patients (82.8%) who received microvascular decompression, 101 (5.7%) who continued to visit the clinic for botulinum toxin injections, and 9 (0.5%) who died or suffered from other diseases. Ninety-two (5.2%) of the patients were lost to follow-up; the remaining 104 were followed up for 5-42 years (mean 12 years) after the onset of the symptoms of HFS. Results: The condition was aggravated in 11 (10.6%) of the 104 patients and stationary in 40 (38.5%) for 6-42 years (mean 13 years). Ten (9.6%) improved partially for 7-18 years (mean 11 years). Forty-three (41.3%) were in remission for between 2 months and 23 years (mean 6.4 years) after onset and required no further treatment for 5 months to 13 years (mean 5.7 years). Conclusion: This study provides useful information to HFS patients for understanding the disease and determining treatment.

Improvement of Hemifacial Spasm after Stent-assisted Coil Embolization for Ipsilateral Vertebral Artery Dissecting Aneurysm

“…Lee et al documented that 41% of untreated HFS cured spontaneously from 2 months to 23 years in their clinical study. 22) However, in our case, the patient realized significant improvement of his unpleasant symptom from just after the endovascular treatment. This fact also suggested an efficacy of our procedure rather than a natural course.…”

Prognostic value of lateral spread response during microvascular decompression for hemifacial spasm

“…Hemifacial spasm (HFS) is a rare neuromuscular disorder characterized by paroxysmal involuntary tonic clonic contractions of unilateral facial muscles, commonly beginning in the orbicularis oculi and spreading to the other facial muscles. 1 HFS has been reported to show a female predominance and to have a higher incidence in Asian compared with other populations. 2 HFS is considered to be caused by vascular compression of the facial nerve at the root exit zone (REZ), and microvascular decompression (MVD) is thus the current gold-standard treatment.…”

Hemifacial Spasm as a Rare Clinical Presentation of Idiopathic Intracranial Hypertension: Case Report and Literature Review

“…2 Treatment options for HFS include botulinum toxin injection to the muscles involved and/or microvascular decompression of the offending vessel. 3…”