Delayed Facial Palsy After Microvascular Decompression for Hemifacial Spasm

Area of Science:

• Neurosurgery
• Neurology
• Facial Nerve Disorders

Background:

• Microvascular decompression (MVD) is a primary treatment for hemifacial spasm (HFS).
• Delayed facial paralysis (DFP) is a potential complication following MVD for HFS.
• Understanding risk factors for DFP is crucial for patient management and outcomes.

Purpose of the Study:

• To identify risk factors associated with the occurrence of delayed facial paralysis (DFP) after microvascular decompression (MVD) for hemifacial spasm (HFS).

Main Methods:

• Retrospective study of 636 patients undergoing MVD for HFS.
• Comparison of 50 patients with DFP to 100 control patients without DFP.
• Univariate and multivariate logistic regression analyses to determine risk factors.

Main Results:

• The duration of hemifacial spasm (HFS) was identified as the sole significant risk factor for developing delayed facial paralysis (DFP) post-MVD (P=0.01).
• A positive correlation was observed between earlier DFP onset and shorter symptom duration (r_s = 0.682; P < 0.001).
• DFP occurred in 7.9% of patients, with an average onset of 12.9 days and spontaneous recovery within 10-300 days.

Conclusions:

• The duration of HFS is a key predictor for DFP following MVD.
• DFP, though common, typically resolves spontaneously.
• Earlier DFP onset is associated with a quicker recovery period.