2017 Volume 26 Issue 4 Pages 263-272
Hemifacial spasm is a syndrome of unilateral facial twitching characterized by frequent, involuntary facial muscle contractions, resulting in impaired quality of life. Since Jannetta first made serendipitous microsurgical observation on microvascular decompression in 1966, the knowledge of hemifacial spasm has increased with advances in neurophysiological technique, diagnostic imaging and surgical experiences. Vascular pulsatile compression on the root exit zone of the facial nerve causes this phenomenon and surgical decompression of the offending vessel has therefore been established as a curative treatment for hemifacial spasm.
Abnormal muscle response, elicited by electrically stimulating one branch of the facial nerve while recording from the muscle innervated by another branch of the facial nerve, is useful for the intraoperative monitoring of hemifacial spasm. Herein, we discuss the pathogenesis, neurophysiology, and intraoperative monitoring of hemifacial spasm.
