• Hua Zhao, Xin Zhang, Ying Zhang, Yin-Da Tang, Jin Zhu, Xu-Hui Wang, Ting-Ting Ying, and Shi-Ting Li.
• Department of Neurosurgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
• World Neurosurg. 2017 Sep 1; 105: 605-611.

BackgroundFew studies have examined atypical hemifacial spasm (AHFS), and the mechanism of AHFS remains unclear. In this study, we examined the etiology, prognosis, and treatment of AHFS.MethodsWe retrospectively analyzed the clinical data for 14 consecutive patients that underwent microvascular decompression (MVD) for AHFS between January 2014 and December 2015. Clinical features, outcomes, and complications were evaluated.ResultsThe incidence of AHFS is 1.52%. There were no significant differences in sex, age, side and duration between the typical hemifacial spasm and AHFS. During the follow-up period, the effective rate of MVD for patients with AHFS was 92.3%. Three patients developed delayed facial nerve palsy postoperatively, 1 patient experienced occipital sensory disturbance, and 1 patient suffered hearing loss.ConclusionsMost of the cases of AHFS studied here were caused by neurovascular conflict in zone IV of the facial nerve distal to the root entry zone. MVD surgery is the first choice treatment for AHFS.Copyright © 2017. Published by Elsevier Inc.

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