HUSCAP logo Hokkaido Univ. logo

Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >

A significant correlation between delayed cure after microvascular decompression and positive response to preoperative anticonvulsant therapy in patients with hemifacial spasm

Files in This Item:
NeurosurgRev39_607.pdf161.14 kBPDFView/Open
Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/67228

Title: A significant correlation between delayed cure after microvascular decompression and positive response to preoperative anticonvulsant therapy in patients with hemifacial spasm
Authors: Terasaka, Shunsuke Browse this author →KAKEN DB
Asaoka, Katsuyuki Browse this author
Yamaguchi, Shigeru Browse this author
Kobayashi, Hiroyuki Browse this author
Motegi, Hiroaki Browse this author
Houkin, Kiyohiro Browse this author →KAKEN DB
Keywords: Anticonvulsant therapy
Clonazepam
Delayed cure
Hemifacial spasm
Microvascular decompression
Issue Date: Oct-2016
Publisher: Springer
Journal Title: Neurosurgical review
Volume: 39
Issue: 4
Start Page: 607
End Page: 613
Publisher DOI: 10.1007/s10143-016-0729-4
PMID: 27235129
Abstract: Objective: Although microvascular decompression (MVD) is a reliable treatment for hemifacial spasm (HFS), the postoperative course is varied. We retrospectively analyzed the resolution pattern of the spasm and specified predictors for delayed cure after MVD. Methods: This study included 114 consecutive patients with typical HFS. All of them were followed-up for at least one year after operation. Patients were divided into three groups depending on the postoperative course: immediate cure, delayed cure, and failure. To identify the predictive factors for delayed cure after MVD, logistic regression analyses were applied using candidate clinical factors, such as duration of symptom, the tendency of the spasm, preoperative medical treatment and offending vessels. Results: Among the 114 patients, 107 patients were cured. For those cured, 65 patients were classified as immediate cure and 42 patients were classified as delayed cure. Cumulative spasm free rate after one week, one month, and 3 months after MVD were 70%, 88%, and 97%, respectively. No predictive factors between the cured and failure groups were observed. According to multivariate analysis, preoperative anticonvulsant therapy was found to be the sole significant predictive factor for delayed cure after MVD (p = 0.025). Conclusions: A significant correlation between delayed cure and preoperative anticonvulsant therapy was found in our study, which suggests that hyperexcitation of the facial nucleus plays an important role in pathogenesis of delayed cure. Therefore, if a patient demonstrating a positive response to preoperative anticonvulsant therapy showed a persistent spasm after MVD, reoperation should be delayed for at least 3 months after the initial operation.
Rights: The final publication is available at Springer via http://dx.doi.org/10.1007/s10143-016-0729-4
Type: article (author version)
URI: http://hdl.handle.net/2115/67228
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 寺坂 俊介

Export metadata:

OAI-PMH ( junii2 , jpcoar )

MathJax is now OFF:


 

 - Hokkaido University