title: Real-time Monitoring of the Lateral Spread Response Resulting from Serial Decompression for Hemifacial Spasm Caused by a Fusiform Aneurysm.
abstract: Fusiform aneurysm as a cause of hemifacial spasm (HFS) is an extremely rare condition. A 69-year-old man developed paroxysmal spasm of his left side facial muscles over a period of 5 years. Radiologic images demonstrated a left vertebral artery (VA) fusiform aneurysm compressing the root entry zone of the left facial nerve. The patient underwent serial surgical procedures for the treatment of HFS under intraoperative electromyography monitoring. Lateral spread response (LSR) did not disappear despite 5 minutes of extracranial left VA ligation and remained after cerebrospinal fluid drainage after dura opening. After interposition of the VA through Teflon felt insertion, the LSR finally disappeared. The patient became symptom free immediately after the surgery and continued as such throughout a follow-up period of 1 year. This is the first report involving real-time monitoring of the LSR changes resulting from serial procedures of decompression in an HFS caused by a fusiform aneurysm of the VA.
authors.affiliation: Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seok Keun
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
authors.forename: Johnho
authors.initials: J
authors.lastname: Kim
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000601:surgery*; D002533:Cerebral Angiography; D004576:Electromyography; D019569:Hemifacial Spasm / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D008026:Ligation; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000473:pathology