Hemifacial spasm: A prospective long term follow up of 83 cases treated by microvascular decompression at two neurosurgical centres in the United Kingdom

Objective-To evaluate the use of microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS). Methods-Eighty three patients with HFS who underwent MVD via a suboccipital craniectomy are presented. Results-Seventy two out of seventy eight patients available for follow up remained free of any spasms at a mean follow up period of eight years. Two patients continued to have minor intermittent muscle twitches and three had recurrence of HFS. One patient's operation was not completed. Twenty had a transient complication and eight were left with permanent postoperative deficits, the commonest being unilateral sensorineural deafness. Seventy one patients declared themselves satisfied with the procedure. A causative vessel was found on the root exit zone of the seventh cranial nerve in 81 patients. Conclusion-The procedure seems to provide lasting relief for most patients. The correct operative technique is essential if complications are to be avoided.