• Ryotaro Yamashita, Taishi Nakamura, Ryutaro Fukuyama, Kosuke Ishikawa, Takahiro Hayashi, Ryohei Miyazaki, Makoto Ohtake, Mitsuru Sato, Kensuke Tateishi, Nobuyuki Shimizu, Jun Suenaga, and Hidetoshi Murata.
• Department of Neurosurgery, Graduate School of Medicine, Yokohama City University.
• No Shinkei Geka. 2017 Mar 1; 45 (3): 247-251.

ObjectiveMicrovascular decompression(MVD)surgery has been established as a standard treatment for hemifacial spasm. However, because decompression surgery results in unfavorable outcomes in some cases, a more critical monitoring strategy is required. To improve surgical outcome for hemifacial spasms, abnormal muscle response(AMR)has been proposed as a tool for intraoperative electrophysiological monitoring during MVD surgery. Here, we report a single case of surgical MVD monitoring using artery wall stimulating electromyography(AWS-EMG). AWS-EMG was developed as a new monitoring method in addition to AMR.Case DescriptionA 60-year-old woman was diagnosed with hemifacial spasm using magnetic resonance imaging and magnetic resonance angiography fusion imaging. We performed MVD surgery using AWS-EMG and AMR. We successfully identified AWS-EMG before decompression and confirmed immediate AWS-EMG loss after decompression. This behavior was consistent with AMR. After surgery, the patient showed no further symptoms of hemifacial spasm.ConclusionsIn addition to AMR, AWS-EMG might be a promising candidate for intraoperative monitoring for patients with hemifacial spasm.

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