title: [Intraoperative Artery Wall Stimulating Electromyography during Microvascular Decompression Surgery to Treat Hemifacial Spasm:A Case Report].
abstract: OBJECTIVE
  Microvascular decompression(MVD)surgery has been established as a standard treatment for hemifacial spasm. However, because decompression surgery results in unfavorable outcomes in some cases, a more critical monitoring strategy is required. To improve surgical outcome for hemifacial spasms, abnormal muscle response(AMR)has been proposed as a tool for intraoperative electrophysiological monitoring during MVD surgery. Here, we report a single case of surgical MVD monitoring using artery wall stimulating electromyography(AWS-EMG). AWS-EMG was developed as a new monitoring method in addition to AMR.
  
  
  METHODS
  A 60-year-old woman was diagnosed with hemifacial spasm using magnetic resonance imaging and magnetic resonance angiography fusion imaging. We performed MVD surgery using AWS-EMG and AMR. We successfully identified AWS-EMG before decompression and confirmed immediate AWS-EMG loss after decompression. This behavior was consistent with AMR. After surgery, the patient showed no further symptoms of hemifacial spasm.
  
  
  CONCLUSIONS
  In addition to AMR, AWS-EMG might be a promising candidate for intraoperative monitoring for patients with hemifacial spasm.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Yokohama City University.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Yamashita
authors.forename: Taishi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Fukuyama
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hayashi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Miyazaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohtake
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sato
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tateishi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimizu
authors.forename: Jun
authors.initials: J
authors.lastname: Suenaga
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Murata
mesh_terms: D001158:Arteries / Q000601:surgery*; D004558:Electric Stimulation / Q000379:methods; D004576:Electromyography / Q000379:methods; D005154:Facial Nerve / Q000601:surgery*; D005260:Female; D019569:Hemifacial Spasm / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D061145:Microvascular Decompression Surgery / Q000379:methods; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome