Hemifacial spasm: a prospective long-term follow up of 83 cases treated by microvascular decompression at two neurosurgical centres in the United Kingdom.

OBJECTIVE

To evaluate the use of microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS).

METHODS

Eighty three patients with HFS who underwent MVD via a suboccipital craniectomy are presented.

RESULTS

Seventy two out of seventy eight patients available for follow up remained free of any spasms at a mean follow up period of eight years. Two patients continued to have minor intermittent muscle twitches and three had recurrence of HFS. One patient's operation was not completed. Twenty had a transient complication and eight were left with permanent postoperative deficits, the commonest being unilateral sensorineural deafness. Seventy one patients declared themselves satisfied with the procedure. A causative vessel was found on the root exit zone of the seventh cranial nerve in 81 patients.

CONCLUSION

The procedure seems to provide lasting relief for most patients. The correct operative technique is essential if complications are to be avoided.