J Clin Neurol.  2018 Jul;14(3):303-309. 10.3988/jcn.2018.14.3.303.

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

• Na BS
• Cho JW
• Park K
• Kwon S
• Kim YS
• Kim JS
• Youn J

• KMID: 2415045
• DOI: http://doi.org/10.3988/jcn.2018.14.3.303

Abstract

BACKGROUND AND PURPOSE
Hemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD).
METHODS
We enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups.
RESULTS
The severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severe-spasm group than in the mild-spasm group. Logistic regression analysis showed that severe-spasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD.
CONCLUSIONS
Spasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD.

Keyword

hemifacial spasm; microvascular decompression; severity; indentation; facial palsy

MeSH Terms

Diabetes Mellitus
Facial Nerve
Facial Paralysis*
Hemifacial Spasm*
Humans
Hypertension
Incidence
Korea
Logistic Models
Microvascular Decompression Surgery
Seoul
Spasm

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