Revisiting the link between hypertension and hemifacial spasm

Abstract

The relationship between hypertension and hemifacial spasm (HFS) has been debated. Microvascular decompression surgery is effective in some HFS patients with uncontrolled hypertension. To address current gaps in knowledge, we conducted a meta-analysis of case-control studies that have examined the prevalence of hypertension in HFS patients compared to non-HFS controls. We also evaluated the implications and limitations of the pooled studies. We identified 62 studies from PubMed, The Cochrane Library, Web of Science and Scholar.google.com and six studies that fit our inclusion criteria were included. A random-effects model was used to derive the pooled estimate of the Odds Ratio. The data was plotted on a Forest plot. A pooled analysis involving 51585 subjects, 549 cases, 720 neurological controls and 50316 controls from the general population, showed that HFS patients had a higher chance of developing hypertension (OR = 1.72, 95% CI = (1.12, 2.31), p-value <0.001). The prevalence of hypertension was higher in HFS patients as compared to non-HFS patients. This meta-analysis highlights a positive correlation between hypertension and HFS. Blood pressure should be closely monitored during the follow-up of HFS patients. Preliminary links between ventrolateral medullary (VLM) compression and HFS should be further evaluated in future studies.

Evaluation of 40 hemifacial spasm patients with MR angiography of the brain and vertebral artery dominance in the etiology of hemifacial spasm

“…Leong et al 17 analysed data from 62 patients who underwent microvascular decompression to determine the relationship between hypertension and HFS, and found that hypertension was more prevalent in patients with than in those without HFS. Peren et al 18 performed colour doppler ultrasonography on nine patients with HFS and a control group, and found that the AICA and PICA flow rates were significantly higher in patients with HFS.…”

Combined hyperactive dysfunction syndrome of the cranial nerves complicated by essential hypertension

“…Li retrospectively analyzed published studies and proposed that MVD may be an effective approach for patients with severe, unstable, and refractory hypertension [5] . In addition, relevant meta-analyses have confirmed the correlation between hypertension and HDS [6] . Legrady retrospectively investigated 13 resistant hypertensive patients, in which systolic and diastolic blood pressures and pulse pressure decreased in all patients following the decompression, and these changes were more remarkable in patients with multiple compressions [7] …”

Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery

“…Previous studies have also focused on the association between vascular dolichoectasia and HFS, concluding that dolichoectasia is usually associated with HTN. 26 27 However, conflicting results have been obtained regarding the relationship between HFS and HTN, 28 29 30 and no study has focused on HTN and spasm severity in patients with HFS. Future studies investigating the association between HTN and HFS pathophysiology will help to elucidate this relationship.…”