Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery.
10.3988/jcn.2018.14.3.303
- Author:
Boo Suk NA
1
;
Jin Whan CHO
;
Kwan PARK
;
Soonwook KWON
;
Ye Sel KIM
;
Ji Sun KIM
;
Jinyoung YOUN
Author Information
1. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. genian@skku.edu
- Publication Type:Original Article
- Keywords:
hemifacial spasm;
microvascular decompression;
severity;
indentation;
facial palsy
- MeSH:
Diabetes Mellitus;
Facial Nerve;
Facial Paralysis*;
Hemifacial Spasm*;
Humans;
Hypertension;
Incidence;
Korea;
Logistic Models;
Microvascular Decompression Surgery;
Seoul;
Spasm
- From:Journal of Clinical Neurology
2018;14(3):303-309
- CountryRepublic of Korea
- Language:English
-
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.
