Clinical analysis of 10 patients with Meige syndrome misdiagnosed as hemifacial spasm taken microvascular decompression surgery

Abstract

Objective To explore the differential diagnosis of Meige syndrome (MS) with hemifacial spasm (HFS) to strengthen the degree of recognition of MS for clinical workers. Methods The clinical data of 10 patients with MS, misdiagnosed as HFS and received microvascular decompression (MVD) surgery in other hospitals and admitted to our hospital from May 2005 to November 2016, were retrospectively analyzed. The different differential diagnosis methods and treatment methods were analyzed. Results These 10 patients with MS, who were misdiagnosed as different sides of HFS, took oral drugs, acupuncture therapy, botulinum toxin injection and facial nerve MVD treatments before they went into our hospital. Relapse appeared in these patients at about 2 years. However, in our hospital, these 10 patients were diagnosed as having MS. According to their clinical symptoms, corresponding treatment regimens for symptomatic treatment were given: 2 patients underwent deep brain stimulation, and 8 patients with oral medication and psychological and behavioral therapies. The eyelid and lips and involuntary symptoms of convulsions improved significantly. Burke-Fahn-Marsden muscular dystonia rating scale indicated that the improvement rate in the 2 patients accepted deep brain stimulation was 54%-89%, and that in the other 8 patients was 23%-59%. Conclusions MS and HFS have a certain degree of similarity in clinical manifestations, and it is easily confused in the clinical work. But the two are completely different in pathogenesis and treatment, and the wrong treatment may bring disastrous consequences to patients, so it’s a great challenge for clinicians to make a clear diagnosis. Key words: Meige syndrome; Hemifacial spasm; Misdiagnosis