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Intraoperative findings of abnormal muscle response for hemifacial spasm following botulinum neurotoxin treatment

  • Original Article - Functional Neurosurgery - Other
  • Published:
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Abstract

Objective

This study aimed to investigate the effect of preoperative botulinum toxin (BTX) injection on intraoperative abnormal muscle response (AMR) in patients with hemifacial spasm (HFS).

Methods

A total of 104 patients (32 men, 72 women) who underwent microvascular decompression (MVD) for HFS were included in this study. A total of 62 patients without and 42 patients with preoperative BTX treatments were assigned to group A and group B, respectively. AMR recordings were obtained from the orbicularis oculi and mentalis muscles by stimulation of the marginal mandibular branch and zygomatic branch of the facial nerve, respectively. The intraoperative AMR monitoring findings and therapeutic effects were compared between groups A and B.

Results

The rates of the patients with unavailable AMRs recorded from the orbicularis oculi muscles in group B (38.1%) were significantly higher than those in group A (14.5%, p = 0.006). Moreover, in cases with over 4 times BTX injection, the recordings of AMR from the orbicularis oculi muscles were poorer than the cases with less BTX injection (p = 0.001). There were no significant differences in the rates of the patients with unavailable AMRs recorded from the mentalis muscles between the two groups. There were no significant differences in the surgical results obtained between the two groups.

Conclusions

Preoperative BTX injections should be less than 4 times to ensure effective AMR monitoring. MVD using AMR monitoring is useful for patients with HFS who were previously treated by BTX as well as those who were not treated.

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Authors and Affiliations

  1. Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757, Asahimachi-dori, Chuo-ku, Niigata, 951-8585, Japan

    Yoko Nakayama & Makoto Oishi

  2. Department of Neurosurgery, Nagaoka Red Cross Hospital, Niigata, Japan

    Tadashi Kawaguchi

  3. Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan

    Masafumi Fukuda

Authors
  1. Yoko Nakayama
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  2. Tadashi Kawaguchi
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  3. Masafumi Fukuda
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  4. Makoto Oishi
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Correspondence to Yoko Nakayama.

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This article is part of the Topical Collection on Functional Neurosurgery—Other

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Nakayama, Y., Kawaguchi, T., Fukuda, M. et al. Intraoperative findings of abnormal muscle response for hemifacial spasm following botulinum neurotoxin treatment. Acta Neurochir 163, 3303–3309 (2021). https://doi.org/10.1007/s00701-021-05017-5

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  • DOI: https://doi.org/10.1007/s00701-021-05017-5

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