Clinical characteristics and efficacy of microvascular decompression for young onset hemifacial spasm patients

Abstract

Objective To investigate the clinical characteristics, causes and surgical treatment of young onset hemifacial spasm patients. Methods A total of 982 patients underwent microvascular decompression (MVD) for hemifacial spasm (HFS) in Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School from January, 2010 to December, 2013. 17 patients with the onset age ≤22 years old were analyzed retrospectively. Results Among the 17 unilateral HFS patients, 4 were males and 13 were females. The mean age of onset was [19.4±2.3(14-22)] years. The mean duration before operation was [5.5±3.0(1-11)] years. The preoperative MRI showed that the average outside diameter of the offending vessels was (1.66±0.81)mm, the average angle of the posterior fossa was (29.92±4.78)°. The offending arteries were observed in all patients. The local anatomic variations and exceptional arteries were found in 14 patients. 16 patients got a clinical resolution, of which 14 cases were cured immediately, delayed resolution (1, 3 months after surgery) was found in two cases, without recurrence during the follow-up period(1-3 years). One patient relapsed 10 d after the surgery. One case of delayed facial paralysis (14 days after surgery) and one hoarseness were observed. Conclusions Young onset HFS patients were rare. Exceptional arteries and anatomic structural variation might be the main causes of this disease. MVD had good effect. Key words: Microvascular decompression surgery; Adolescent; Disease attributes; Hemifacial spasm