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Hemifacial spasm: a review.

R H Wilkins1

  • 1Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina.

Surgical Neurology
|October 1, 1991
PubMed
Summary

Hemifacial spasm, often caused by facial nerve compression, is best treated with microvascular decompression. Intraoperative monitoring of auditory evoked potentials can help prevent hearing loss, a known surgical risk.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Otolaryngology

Background:

  • Hemifacial spasm is a neurological disorder characterized by involuntary contractions of facial muscles.
  • The primary cause is typically compression of the facial nerve (CN VII) at the brainstem (pons), often by a blood vessel.

Purpose of the Study:

  • To review the diagnosis and most effective treatment for hemifacial spasm.
  • To highlight the risks associated with surgical intervention and methods to mitigate them.

Main Methods:

  • Diagnosis relies on clinical observation and patient history.
  • The gold standard treatment involves microvascular decompression (MVD) of the facial nerve at the pons.
  • Intraoperative monitoring of auditory evoked potentials (AEPs) is employed during surgery.

Main Results:

  • Microvascular decompression is the most effective treatment for hemifacial spasm.
  • A significant risk of MVD is ipsilateral (on the same side) hearing loss.
  • Auditory evoked potential monitoring effectively identifies and helps prevent this complication.

Conclusions:

  • Hemifacial spasm is effectively managed with microvascular decompression.
  • Intraoperative auditory evoked potential monitoring is crucial for preserving hearing during MVD surgery for hemifacial spasm.
  • This monitoring technique enhances surgical safety and patient outcomes.

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