title: The mechanism of hemifacial spasm: a new understanding of the offending artery.
abstract: Although neurovascular confliction was believed to be the cause of hemifacial spasm (HFS), the mechanism of the disorder remains unclear to date. Current theories, merely focusing on the facial nerve, have failed to explain the clinical phenomenon of immediate relief following a successful microvascular decompression surgery (MVD). With the experience of thousands of microvascular decompression surgeries and preliminary investigations, we have learned that the offending artery may play a more important role than the effect of merely mechanical compression in the pathogenesis of the disease. We believe that the attrition of neurovascular interface is the essence of the etiology, and the substance of the disease is emersion of ectopic action potentials from the demyelinated facial nerve fibers, which were triggered by the sympathetic endings from the offending artery wall. In this paper, we put forward evidence to support this hypothesis, both logically and theoretically.
authors.forename: Ning-Ning
authors.initials: NN
authors.lastname: Dou
authors.forename: Jun
authors.initials: J
authors.lastname: Zhong
authors.forename: Qiu-Meng
authors.initials: QM
authors.lastname: Zhou
authors.forename: Jin
authors.initials: J
authors.lastname: Zhu
authors.forename: Yong-Nan
authors.initials: YN
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Xia
authors.forename: Xiao-Sheng
authors.initials: XS
authors.lastname: Yang
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Ying
authors.forename: Xue-Sheng
authors.initials: XS
authors.lastname: Zheng
authors.forename: Shi-Ting
authors.initials: ST
authors.lastname: Li
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D003711:Demyelinating Diseases / Q000503:physiopathology*; D005154:Facial Nerve / Q000503:physiopathology* / Q000648:ultrastructure; D019569:Hemifacial Spasm / Q000209:etiology* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D061145:Microvascular Decompression Surgery
keywords: Ectopic excitability; Hemifacial spasm,; Microvascular decompression,; Pathogenesis,; Sympathetic endings,