• Jun Gao, Kuan-zheng Li, Yi Guo, Wan-chen Dou, Yong-ning Li, and Ren-zhi Wang.
• Department of Neurosurgery, Chinese Academy of Medical Sciences, Beijing, China.
• Zhonghua Yi Xue Za Zhi. 2011 Nov 8; 91 (41): 2920-2.

ObjectiveTo explore the clinical efficacy of microvascular decompression plus intraoperative monitoring of abnormal muscle response in the treatment of hemifacial spasm.MethodsBetween 2009 and 2010, a total of 47 patients underwent microvascular decompression for hemifacial spasm. There were 15 males and 32 females with an age range 23 - 70 years old. During operations, intermittent electrical pulses were applied to stimulate the zygomatic branch of facial nerve at the spasm side. And evoked potentials were monitored in orbicularis oris. All patients were followed up for 5 - 22 months.ResultsThe abnormal muscle responses were recorded pre-operatively in all 47 patients at the spasm side. In 42 patients, the abnormal muscle responses disappeared at the different stages of operations (4 while opening dura, 9 while dissecting arachnoid membrane and 29 while separating responsible vessels). All 42 patients were cured during the follow-up period. In the remaining 5 patients, the abnormal muscle response were still recorded even at the end of operations. Two of 5 patients were free from spasm during the follow-up period while the symptoms of other 3 patients became obviously relieved.ConclusionThe combined approaches of microvascular decompression and intraoperative monitoring of abnormal muscle response may assist the identification of responsible vessels and improve the outcomes of hemifacial spasm.

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