title: [Hemifacial spasms caused by neurovascular compression].
abstract: Three patients, one woman aged 52 years and two men aged 63 and 71 years, respectively, had involuntary movement on one side of their face due to hemifacial spasms. The first patient's spasms were misdiagnosed as a tic, the second patient had received injections of botulinum A toxin which gave no improvement and the third patient suffered from persistent symptoms after a first neurovascular decompression without intraoperative EMG monitoring. All three patients underwent microvascular decompression of the facial nerve with intraoperative EMG monitoring. All three patients were cured. Hemifacial spasm is a curable illness if appropriately diagnosed and treated. Oral medications have no effect on the disease. Local injection of botulinum A toxin is indicated when the spasm is mild or when surgery is contraindicated. The primary causative factor is vascular compression of the facial nerve at its exit zone. Therefore, decompressive surgery is the logical treatment, and the best results are obtained with intraoperative EMG monitoring.
authors.affiliation: Afd. Neurochirurgie, Academisch Ziekenhuis, Postbus 30.001, 9700 RB Groningen. m.k.mustafa@int.azg.nl
authors.forename: M K
authors.initials: MK
authors.lastname: Mustafa
authors.forename: T W
authors.initials: TW
authors.lastname: van Weerden
authors.forename: J J A
authors.initials: JJ
authors.lastname: Mooij
mesh_terms: D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D019299:Decompression, Surgical / Q000379:methods*; D004576:Electromyography; D005154:Facial Nerve / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D009465:Neuromuscular Agents / Q000627:therapeutic use; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A