title: Application of electrophysiological methods and magnetic resonance tomographic angiography in the differentiation between hemifacial spasm and Meige syndrome.
abstract: Bilateral hemifacial spasm and Meige syndrome can be easily confused due to their similar clinical manifestation. Here, we aimed to investigate the application of electrophysiological methods and magnetic resonance tomographic angiography (MRTA) in the differentiation between hemifacial spasm and Meige syndrome. 10 patients with bilateral hemifacial spasm and 9 patients with Meige syndrome received electrophysiological monitoring of nerves. There were two males and eight females with bilateral hemifacial spasm, aged 16-58 years with a course of 5-54 months. For the patients with Meige syndrome, there were three males and six females, aged 51-68 years with a course of 12-36 months. All patients received conventional MRTA of the brain blood vessels before decompression. We found that all patients with Meige syndrome showed synchronous contraction of bilateral orbicularis oculi muscles and (or) burst discharge from orbicularis oris muscles in surface electromyography (sEMG). However, those with hemifacial spasm presented with bilaterally asynchronous burst discharge. Electromyography for patients with Meige syndrome did not record abnormal muscle response (AMR), but recorded AMR for those with bilateral hemifacial spasm. The offending vessels were compressed in patients with hemifacial spasm in MRTA, while MRTA results were generally negative for those with Meige syndrome. Combining sEMG and AMR detection in EMG and MRTA, bilateral hemifacial spasm can be differentiated from Meige syndrome with a reduction of misdiagnosis rate.
authors.affiliation: Medical Center, Tsinghua University, No. 30 Shuangqing Road, Haidian District, Beijing, 100084, China.|Department of Neurosurgery, Tsinghua University Yuquan Hospital, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100049, China.
authors.forename: Chuyi
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Tsinghua University Yuquan Hospital, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100049, China.
authors.forename: Suhua
authors.initials: S
authors.lastname: Miao
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, No.12 Mid. Wulumuqi Road, Shanghai, 200040, China.
authors.forename: Heling
authors.initials: H
authors.lastname: Chu
authors.affiliation: Medical Center, Tsinghua University, No. 30 Shuangqing Road, Haidian District, Beijing, 100084, China.
authors.forename: Aikeremujiang
authors.initials: A
authors.lastname: Muheremu
authors.affiliation: Department of Neurosurgery, Tsinghua University Yuquan Hospital, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100049, China.
authors.forename: Jinting
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Tsinghua University Yuquan Hospital, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100049, China.
authors.forename: Rongsong
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, Tsinghua University Yuquan Hospital, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100049, China. zuohc@tsinghua.edu.cn.
authors.forename: Huancong
authors.initials: H
authors.lastname: Zuo
authors.affiliation: Department of Neurosurgery, Tsinghua University Yuquan Hospital, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100049, China. lymayu@163.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D019569:Hemifacial Spasm / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008538:Meige Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Abnormal muscle response wave; Electrophysiology; Hemifacial spasms; Magnetic resonance tomographic angiography; Meige syndrome
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