Objective: We investigated the clinical meaning of the severity of hemifacial spasm (HFS) in the patients who performed microvascular decompression (MVD).

Background: Even though the most common cause of HFS is known as the compression of the facial nerves by cerebral vessels, the meaning of severity of spasm is not clearly elucidated.

Methods: We enrolled 636 HFS patients who underwent MVD from February 2009 to December 2012 at the Samsung Medical Center in Seoul, Korea. Subjects were divided into two groups based on severity of HFS; severe spasm group (patients with spasm of SMC grade 3-4) and mild spasm group (subjects with spasm of SMC grade 1-2). We compared demographic, clinical and surgical data between two groups.

Results: Severe spasm group had older mean age at MVD, and more hypertension than mild spasm group. Additionally, severe spasm group demonstrated longer disease duration. In terms of surgical data, severe spasm group had more subjects with multiple offending vessels in severe spasm group, and more severe indentation comparing with mild spasm group. In logistic regression analysis, these forementioned variables were still related with the severity of HFS. However, the severity of spasm was not related with outcome or complication after MVD.

Conclusions: Considering severe spasm group revealed similar cure rate and complication rate with mild spasm group, MVD could be an effective treatment option, especially in HFS patients with severe spasm because severe spasm was associated with severe indentation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/what-does-the-severity-of-hemifacial-spasm-mean-to-us/