Abdul Hameed, Naveed Ashraf, Mohammad Akmal, Talha Abbas.
Surgical management of hemifacial spasm.
Pak J Med Health Sci Jan ;4(4):460-3.

Back ground: Hemifacial spasm is a syndrome of spontaneous and gradual onset that has its hallmark the intermittent twitching of the muscles of facial expression on one side of the face. Characteristically, a series of twitches, increasing in frequency and intensity are followed by a sustained spasm lasting a few seconds to a few minutes. Hemifacial spasm occurs almost exclusively in adults. It presents primarily as a problem of appearance for the affected individual, but when it becomes marked it may interfere with daily activities. A wide variety of agents have been mentioned as the cause of Hemifacial spasm but in most of the patients the cause seems to be the compression of the facial nerve by a neighbouring vessel near brain stem. Various treatment modalities have been employed with reference to the presumed cause but Micro vascular Decompression of the facial nerve in the posterior fossa gives the most promising results. Material and methods: A series of 14 patients of Hemifacial spasm presenting to us in the Department of Neurosurgery Jinnah hospital Lahore from August 2006 to September 2009 were studied. Micro vascular decompression of the facial nerve was done in all these patients. Female were 08 and males were 06. The average age was 41 years and average conservative management period was 05 years. Out of 14 patients 06 had right sided and 08 had left sided involvement. Results: In 11 patients an arterial loop was found responsible and venous loop pressure was in one present and both arterial and venous loops in 02 patients. There were minimal complications and only one recurrence has been noted till today.

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