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

Terasaka, Shunsuke; Asaoka, Katsuyuki; Yamaguchi, Shigeru; Kobayashi, Hiroyuki; Motegi, Hiroaki; Houkin, Kiyohiro

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

Terasaka, Shunsuke; Asaoka, Katsuyuki; Yamaguchi, Shigeru et al.

Neurosurgical review, 2016, 39(4), 607-613

Permalink : https://hdl.handle.net/2115/67228

このアイテムのアクセス数:861件（2026-08-26 04:07 集計）

閲覧可能ファイル

ファイル	フォーマット	サイズ	閲覧回数	説明
NeurosurgRev39_607	pdf	161 KB	1,171

論文情報

ファイル出力 EndNote Basic出力 Mendeley出力

アクセス権	open access
URI	https://hdl.handle.net/2115/67228
タイトル	A significant correlation between delayed cure after microvascular decompression and positive response to preoperative anticonvulsant therapy in patients with hemifacial spasm
著者	Terasaka, Shunsuke ; Asaoka, Katsuyuki ; Yamaguchi, Shigeru ; Kobayashi, Hiroyuki ; Motegi, Hiroaki ; Houkin, Kiyohiro
e-Rad_Researcher 10447055 著者名 Terasaka, Shunsuke
著者名 Asaoka, Katsuyuki
著者名 Yamaguchi, Shigeru
著者名 Kobayashi, Hiroyuki
著者名 Motegi, Hiroaki
e-Rad_Researcher 90229146 著者名 Houkin, Kiyohiro
言語	英語
キーワード	Anticonvulsant therapy
	Clonazepam
	Delayed cure
	Hemifacial spasm
	Microvascular decompression
発行日	2016-10
出版者	Springer
収録物名	Neurosurgical review
巻(号)	39(4)
ページ	607-613
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	The final publication is available at Springer via http://dx.doi.org/10.1007/s10143-016-0729-4
PISSN	0344-5607
関連情報	PMID 27235129
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s10143-016-0729-4