Acta Neurochir (2015) 157:467–468 DOI 10.1007/s00701-015-2343-6
LETTER TO THE EDITOR - FUNCTIONAL
Bilateral hemifacial spasm might be cured by unilateral microvascular decompression Ning-Ning Dou & Lei Xia & Ming-Xing Liu & Jun Zhong
Received: 8 September 2014 / Accepted: 5 January 2015 / Published online: 20 January 2015 # Springer-Verlag Wien 2015
Dear Editor, Despite hemifacial spasm and microvascular decompression (MVD) being well known today, bilateral hemifacial spasm has been seldom highlighted in the literature [2, 3, 5]. As the aetiology of bilateral hemifacial spasm remains controversial, most of the patients have been treated with prescription drugs or botulinum toxin injection [4, 6], which may relieve the symptoms in the early stage but do not cure the disease. We report the cases of nine patients with bilateral hemifacial sp as m w h o un de rwe n t MV D in ou r de pa rtm en t. Interestingly, their contralateral spasm also stopped in three patients and improved in one, while the ipsilataral symptom disappeared completely after the one-side MVD. For the remaining five patients without contralateral improvement, four of them had another MVD in the other side within 1 year and the symptom relieved after the second MVD. During the follow-up period, no hearing loss, facial palsy or recurrence was observed. How could one-side MVD solve the bilateral symptoms? We assumed that the contralateral offending artery might also be transposed while the ipsilateral offending artery was removed. As the cerebellar arteries were communicated by the basilar artery, a little transposition of the basilar artery might lead to a separation of neurovascular contact. It has been reported that the abnormal muscle response (AMR) could have disappeared before the neurovascular conflict was discovered, because those procedures (e.g. suction of cerebrospinal fluid N.
LETTER TO THE EDITOR - FUNCTIONAL
Bilateral hemifacial spasm might be cured by unilateral microvascular decompression Ning-Ning Dou & Lei Xia & Ming-Xing Liu & Jun Zhong
Received: 8 September 2014 / Accepted: 5 January 2015 / Published online: 20 January 2015 # Springer-Verlag Wien 2015
Dear Editor, Despite hemifacial spasm and microvascular decompression (MVD) being well known today, bilateral hemifacial spasm has been seldom highlighted in the literature [2, 3, 5]. As the aetiology of bilateral hemifacial spasm remains controversial, most of the patients have been treated with prescription drugs or botulinum toxin injection [4, 6], which may relieve the symptoms in the early stage but do not cure the disease. We report the cases of nine patients with bilateral hemifacial sp as m w h o un de rwe n t MV D in ou r de pa rtm en t. Interestingly, their contralateral spasm also stopped in three patients and improved in one, while the ipsilataral symptom disappeared completely after the one-side MVD. For the remaining five patients without contralateral improvement, four of them had another MVD in the other side within 1 year and the symptom relieved after the second MVD. During the follow-up period, no hearing loss, facial palsy or recurrence was observed. How could one-side MVD solve the bilateral symptoms? We assumed that the contralateral offending artery might also be transposed while the ipsilateral offending artery was removed. As the cerebellar arteries were communicated by the basilar artery, a little transposition of the basilar artery might lead to a separation of neurovascular contact. It has been reported that the abnormal muscle response (AMR) could have disappeared before the neurovascular conflict was discovered, because those procedures (e.g. suction of cerebrospinal fluid N.
