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What range of stimulus intensities should we apply to elicit abnormal muscle response in microvascular decompression for hemifacial spasm?

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Abstract

Background

Abnormal muscle response (AMR) has been considered as a predictor of the prognosis after microvascular decompression (MVD) for hemifacial spasm (HFS). However, its predictive value has not always been satisfactory. The objective of this work was to confirm an optimal range of stimulus intensities to elicit AMR in surgery.

Methods

Seventy-two consecutive patients with primary HFS treated by MVD were retrospectively included in this study. A wide range of stimulus intensities from 1 to 100 mA was applied in AMR monitoring. The AMR-elicited threshold value was quantitatively traced throughout all surgical procedures. The relationship between clinical outcomes and electrophysiological findings was analyzed.

Results

Of the 72 patients, 44 were immediately cured and 24 were delayed cured; the remaining 4 were proved not to be cured in their follow-up periods. The patterns of AMR-elicited threshold changes were categorized into five types, which could only be discriminated with a wide range of stimulus intensities. The constituent ratio of the patterns was significantly different (P < 0.001) among the clinical outcomes.

Conclusions

Some patterns of AMR changes might have been ignored if we had only applied a narrow range of stimulus intensities (1–30 mA) to judge whether AMR disappeared or not. Thus, a wide range of stimulus intensities (1–100 mA) to trace the AMR-elicited threshold values was proposed for a more precise prediction.

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References

  1. Digre K, Corbett JJ (1988) Hemifacial spasm: differential diagnosis, mechanism, and treatment. Adv Neurol 49:151–176

    CAS  PubMed  Google Scholar 

  2. Fukuda M, Oishi M, Takao T, Hiraishi T, Sato Y, Fujii Y (2012) Monitoring of abnormal muscle response and facial motor evoked potential during microvascular decompression for hemifacial spasm. Surg Neurol Int 3:118

    Article  PubMed  PubMed Central  Google Scholar 

  3. Gardner WJ (1962) Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19:947–958

    Article  CAS  PubMed  Google Scholar 

  4. Hatem J, Sindou M, Vial C (2001) Intraoperative monitoring of facial EMG responses during microvascular decompression for hemifacial spasm. Prognostic value for long-term outcome: a study in a 33-patient series. Br J Neurosurg 15:496–499

    Article  CAS  PubMed  Google Scholar 

  5. Hirono S, Yamakami I, Sato M, Kado K, Fukuda K, Nakamura T, Higuchi Y, Saeki N (2014) Continuous intraoperative monitoring of abnormal muscle response in microvascular decompression for hemifacial spasm; a real-time navigator for complete relief. Neurosurg Rev 37:311–320

    Article  PubMed  Google Scholar 

  6. Ishikawa M, Nakanishi T, Takamiya Y, Namiki J (2001) Delayed resolution of residual hemifacial spasm after microvascular decompression operations. Neurosurgery 49:847–856

    CAS  PubMed  Google Scholar 

  7. Jannetta PJ (1975) The cause of hemifacial spasm: definitive microsurgical treatment at the brainstem in 31 patients. Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol 80:319–322

    CAS  PubMed  Google Scholar 

  8. Joo WI, Lee KJ, Park HK, Chough CK, Rha HK (2008) Prognostic value of intra-operative lateral spread response monitoring during microvascular decompression in patients with hemifacial spasm. J Clin Neurosci 15:1335–1339

    Article  PubMed  Google Scholar 

  9. Kemp LW, Reich SG (2004) Hemifacial spasm. Curr Treat Options Neurol 6:175–179

    Article  PubMed  Google Scholar 

  10. Kitai ST, Tanaka T, Tsukahara N, Yu H (1972) The facial nucleus of cat: antidromic and synaptic activation and peripheral nerve representation. Exp Brain Res 16:161–183

    Article  CAS  PubMed  Google Scholar 

  11. Kiya N, Bannur U, Yamauchi A, Yoshida K, Kato Y, Kanno T (2001) Monitoring of facial evoked EMG for hemifacial spasm: a critical analysis of its prognostic value. Acta Neurochir (Wien) 143:365–368

    Article  CAS  Google Scholar 

  12. Li S, Hong W, Tang Y, Ying T, Zhang W, Li X, Zhu J, Zhong J, Hua X, Xu S, Wan L, Wang X, Yang M, Li Y, Zheng X (2010) Re-operation for persistent hemifacial spasm after microvascular decompression with the aid of intraoperative monitoring of abnormal muscle response. Acta Neurochir (Wien) 152:2113–2118

    Article  Google Scholar 

  13. Moller AR, Jannetta PJ (1984) On the origin of synkinesis in hemifacial spasm: results of intracranial recordings. J Neurosurg 61:569–576

    Article  CAS  PubMed  Google Scholar 

  14. Moller AR, Jannetta PJ (1985) Hemifacial spasm: results of electrophysiologic recording during microvascular decompression operations. Neurology 35:969–974

    Article  CAS  PubMed  Google Scholar 

  15. Moller AR, Jannetta PJ (1985) Microvascular decompression in hemifacial spasm: intraoperative electrophysiological observations. Neurosurgery 16:612–618

    Article  CAS  PubMed  Google Scholar 

  16. Mooij JJ, Mustafa MK, van Weerden TW (2001) Hemifacial spasm: intraoperative electromyographic monitoring as a guide for microvascular decompression. Neurosurgery 49:1365–1371

    Article  CAS  PubMed  Google Scholar 

  17. Møller AR (2011) Generation of electrical activity in the nervous system and muscles. In: Møller AR (ed) Intraoperative neurophysiological monitoring, 3rd edn. Springer, New York, pp 23–41

    Chapter  Google Scholar 

  18. Møller AR, Jannetta PJ (1987) Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm. J Neurosurg 66:681–685

    Article  PubMed  Google Scholar 

  19. Neves DO, Lefaucheur JP, de Andrade DC, Hattou M, Ahdab R, Ayache SS, Le GC, Keravel Y (2009) A reappraisal of the value of lateral spread response monitoring in the treatment of hemifacial spasm by microvascular decompression. J Neurol Neurosurg Psychiatry 80:1375–1380

    Article  CAS  PubMed  Google Scholar 

  20. Nielsen VK (1984) Pathophysiology of hemifacial spasm: I. Ephaptic transmission and ectopic excitation. Neurology 34:418–426

    Article  CAS  PubMed  Google Scholar 

  21. Ogawara K, Kuwabara S, Kamitsukasa I, Mizobuchi K, Misawa S, Hattori T (2004) Trigeminal afferent input alters the excitability of facial motoneurons in hemifacial spasm. Neurology 62:1749–1752

    Article  CAS  PubMed  Google Scholar 

  22. Sekula RF Jr, Bhatia S, Frederickson AM, Jannetta PJ, Quigley MR, Small GA, Breisinger R (2009) Utility of intraoperative electromyography in microvascular decompression for hemifacial spasm: a meta-analysis. Neurosurg Focus 27:E10

    Google Scholar 

  23. Sindou MP (2005) Microvascular decompression for primary hemifacial spasm. Importance of intraoperative neurophysiological monitoring. Acta Neurochir (Wien) 147:1019–1026

    Article  CAS  Google Scholar 

  24. Tobishima H, Hatayama T, Ohkuma H (2014) Relation between the persistence of an abnormal muscle response and the long-term clinical course after microvascular decompression for hemifacial spasm. Neurol Med Chir (Tokyo) 54:474–482

    Article  Google Scholar 

  25. Wang A, Jankovic J (1998) Hemifacial spasm: clinical findings and treatment. Muscle Nerve 21:1740–1747

    Article  CAS  PubMed  Google Scholar 

  26. Wilkinson MF, Kaufmann AM (2005) Monitoring of facial muscle motor evoked potentials during microvascular decompression for hemifacial spasm: evidence of changes in motor neuron excitability. J Neurosurg 103:64–69

    Article  PubMed  Google Scholar 

  27. Yamashita S, Kawaguchi T, Fukuda M, Watanabe M, Tanaka R, Kameyama S (2005) Abnormal muscle response monitoring during microvascular decompression for hemifacial spasm. Acta Neurochir (Wien) 147:933–937

    Article  CAS  Google Scholar 

  28. Yang M, Zheng X, Ying T, Zhu J, Zhang W, Yang X, Li S (2014) Combined intraoperative monitoring of abnormal muscle response and Z-L response for hemifacial spasm with tandem compression type. Acta Neurochir (Wien) 156:1161–1166

    Article  Google Scholar 

  29. Ying TT, Li ST, Zhong J, Li XY, Wang XH, Zhu J (2011) The value of abnormal muscle response monitoring during microvascular decompression surgery for hemifacial spasm. Int J Surg 9:347–351

    Article  PubMed  Google Scholar 

  30. Zhong J, Xia L, Dou NN, Ying TT, Zhu J, Liu MX, Li ST (2015) Delayed relief of hemifacial spasm after microvascular decompression: can it be avoided. Acta Neurochir (Wien) 157:93–99

    Article  Google Scholar 

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Acknowledgments

This study was supported by the Graduate Students Innovation Foundation of Peking Union Medical College (grant no. 2015-1002-02-25).

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Authors and Affiliations

  1. Department of Neurosurgery, China-Japan Friendship Hospital, No. 2, Yinghua East Street, Beijing, 100029, China

    Ge Jia, Li Zhang, Hongxiang Ren, Jun Xu, Xiaoli Xu & Yanbing Yu

  2. Graduate School of Peking Union Medical College, No. 9, Dongdan three, Beijing, 100730, China

    Ge Jia & Yanbing Yu

Authors
  1. Ge Jia
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  2. Li Zhang
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  3. Hongxiang Ren
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  4. Jun Xu
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  5. Xiaoli Xu
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  6. Yanbing Yu
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Corresponding author

Correspondence to Yanbing Yu.

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Ethical approval

This retrospective study was approved by the Ethics Committee of China-Japan Friendship Hospital. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Jia, G., Zhang, L., Ren, H. et al. What range of stimulus intensities should we apply to elicit abnormal muscle response in microvascular decompression for hemifacial spasm?. Acta Neurochir 159, 251–257 (2017). https://doi.org/10.1007/s00701-016-2999-6

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  • DOI: https://doi.org/10.1007/s00701-016-2999-6

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