Abstract
Objectives During microvascular decompression (MVD) of the facial nerve for hemifacial spasm (HFS), an abnormal muscle response can be recorded upon stimulation of the facial nerve, also known as the lateral spread response. This response may vanish after MVD and has been associated with a successful outcome. The purpose of this study was to determine if resolution of lateral spread correlated with the elimination of HFS in a single surgeon's experience. Design and Setting (1) Retrospective analysis of 38 patients undergoing MVD with intraoperative electromyography for HFS. (2) Meta-analysis of studies from the literature. Main Outcome Measure Presence or absence of HFS and any complications. Results Lateral spread response was seen in 36 patients; 20 patients had full resolution. Of these, 15 patients became HFS free, and 5 five patients still had some degree of HFS. Sixteen patients had a persistent lateral spread response despite a technically successful MVD; 11 of these became spasm free, and 5 still suffered from some degree of facial twitching. Analyzing 16 studies reporting a total of 1301 patients, a significant correlation (p < 0.0001) between response cessation and resolution of HFS was found. Conclusion The role of monitoring lateral spread response as a predictor for clinical outcome is limited.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 198-203 |
| Number of pages | 6 |
| Journal | Journal of Neurological Surgery, Part B: Skull Base |
| Volume | 75 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2014 |
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Keywords
- hemifacial spasm
- intraoperative monitoring
- lateral spread response
- microvascular decompression
ASJC Scopus subject areas
- Clinical Neurology
Cite this
The significance of intraoperative electromyographic lateral spread in predicting outcome of microvascular decompression for hemifacial spasm. / Eckardstein, Kajetan Von; Harper, Charles; Castner, Marina; Link, Michael.
In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 75, No. 3, 2014, p. 198-203.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The significance of intraoperative electromyographic lateral spread in predicting outcome of microvascular decompression for hemifacial spasm
AU - Eckardstein, Kajetan Von
AU - Harper, Charles
AU - Castner, Marina
AU - Link, Michael
PY - 2014
Y1 - 2014
N2 - Objectives During microvascular decompression (MVD) of the facial nerve for hemifacial spasm (HFS), an abnormal muscle response can be recorded upon stimulation of the facial nerve, also known as the lateral spread response. This response may vanish after MVD and has been associated with a successful outcome. The purpose of this study was to determine if resolution of lateral spread correlated with the elimination of HFS in a single surgeon's experience. Design and Setting (1) Retrospective analysis of 38 patients undergoing MVD with intraoperative electromyography for HFS. (2) Meta-analysis of studies from the literature. Main Outcome Measure Presence or absence of HFS and any complications. Results Lateral spread response was seen in 36 patients; 20 patients had full resolution. Of these, 15 patients became HFS free, and 5 five patients still had some degree of HFS. Sixteen patients had a persistent lateral spread response despite a technically successful MVD; 11 of these became spasm free, and 5 still suffered from some degree of facial twitching. Analyzing 16 studies reporting a total of 1301 patients, a significant correlation (p < 0.0001) between response cessation and resolution of HFS was found. Conclusion The role of monitoring lateral spread response as a predictor for clinical outcome is limited.
AB - Objectives During microvascular decompression (MVD) of the facial nerve for hemifacial spasm (HFS), an abnormal muscle response can be recorded upon stimulation of the facial nerve, also known as the lateral spread response. This response may vanish after MVD and has been associated with a successful outcome. The purpose of this study was to determine if resolution of lateral spread correlated with the elimination of HFS in a single surgeon's experience. Design and Setting (1) Retrospective analysis of 38 patients undergoing MVD with intraoperative electromyography for HFS. (2) Meta-analysis of studies from the literature. Main Outcome Measure Presence or absence of HFS and any complications. Results Lateral spread response was seen in 36 patients; 20 patients had full resolution. Of these, 15 patients became HFS free, and 5 five patients still had some degree of HFS. Sixteen patients had a persistent lateral spread response despite a technically successful MVD; 11 of these became spasm free, and 5 still suffered from some degree of facial twitching. Analyzing 16 studies reporting a total of 1301 patients, a significant correlation (p < 0.0001) between response cessation and resolution of HFS was found. Conclusion The role of monitoring lateral spread response as a predictor for clinical outcome is limited.
KW - hemifacial spasm
KW - intraoperative monitoring
KW - lateral spread response
KW - microvascular decompression
UR - http://www.scopus.com/inward/record.url?scp=84903819683&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903819683&partnerID=8YFLogxK
U2 - 10.1055/s-0034-1368145
DO - 10.1055/s-0034-1368145
M3 - Article
AN - SCOPUS:84903819683
VL - 75
SP - 198
EP - 203
JO - Journal of Neurological Surgery, Part B: Skull Base
JF - Journal of Neurological Surgery, Part B: Skull Base
SN - 2193-6331
IS - 3
ER -