• Ning-Ning Dou, Jun Zhong, Ming-Xing Liu, Lei Xia, Hui Sun, Bin Li, and Shi-Ting Li.
• Department of Neurosurgery, XinHua Hospital (The Cranial Nerve Disease Center of Shanghai), Shanghai JiaoTong University School of Medicine, Shanghai, China.
• World Neurosurg. 2016 Mar 1; 87: 640-5.

BackgroundBilateral hemifacial spasm (HFS) is very rare. The literature contains only 32 clinical reports. Although microvascular decompression (MVD) is widely accepted as effective therapy for HFS, the etiology and surgical treatment of bilateral HFS are seldom addressed. We report our experience with MVD for patients with bilateral HFS.MethodsThis retrospective report included 10 patients with bilateral HFS. All patients underwent MVD 1 or 2 times and were followed for 5-92 months. The clinical data were retrospectively analyzed. The etiology and treatment strategies were discussed.ResultsSpasm stopped completely on the operative side in all 10 patients. Symptoms on the other side also resolved in 3 patients, improved in 1 patient, and did not improve at all in 6 patients. Of the 6 patients with no improvement, 5 underwent another MVD on the contralateral side within 1 year and experienced relief of symptoms, and 1 patient refused the surgery. The neurovascular conflict was found in all the operations. During the follow-up period, no complications of hearing loss or facial palsy and no recurrence were observed.ConclusionsVascular compression was the cause of bilateral HFS in our patients, and MVD relieved the symptoms. Thus, we recommend MVD for patients with bilateral HFS. A crowded cerebellopontine angle space and easy attrition of the neurovascular interfaces may play important roles in the occurrence of bilateral HFS. For some patients, 1 MVD can resolve bilateral symptoms.Copyright © 2016 Elsevier Inc. All rights reserved.

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