Isu T, Kamada K, Mabuchi S, Kitaoka A, Ito T, Koiwa M, Abe H
Department of Neurosurgery, Kushiro Rousai Hospital, Japan.
Acta Neurochir (Wien). 1996;138(1):19-23; discussion 23. doi: 10.1007/BF01411718.
The facial electromyographic response was monitored intraoperatively in 40 patients with hemifacial spasm who were operated on by microvascular decompression of the facial nerve. All 40 patients showed an abnormal facial electromyographic response (lateral spread response) with a latency of about 10 msec after stimulation. The abnormal response resolved before decompression in 22, resolved immediately with decompression in 16, and failed to resolve in two. Of the 38 patients in whom the abnormal response disappeared during surgery, 36 were postoperatively free from hemifacial spasm and two had mild hemifacial spasm. The two patients in whom the lateral spread response did not disappear during surgery showed persistent hemifacial spasm. In conclusion. Disappearance of the lateral spread response during surgery correlated with the absence of hemifacial spasm in the early postoperative period. The prognosis of hemifacial spasm was good in cases in whom the lateral spread response disappeared. Therefore, the authors think that intra-operative facial electromyography is very useful in assessing the efficacy of microvascular decompression and in predicting the prognosis of hemifacial spasm.
对40例接受面神经微血管减压术治疗的面肌痉挛患者术中监测面部肌电图反应。所有40例患者均表现出异常的面部肌电图反应（侧方扩散反应），刺激后潜伏期约为10毫秒。22例患者在减压前异常反应消失，16例在减压后立即消失，2例未消失。在手术中异常反应消失的38例患者中，36例术后无面肌痉挛，2例有轻度面肌痉挛。手术中侧方扩散反应未消失的2例患者表现为持续性面肌痉挛。总之，手术中侧方扩散反应的消失与术后早期无面肌痉挛相关。侧方扩散反应消失的面肌痉挛患者预后良好。因此，作者认为术中面部肌电图在评估微血管减压术的疗效和预测面肌痉挛的预后方面非常有用。
