Microvascular decompression of the facial nerve for hemifacial spasm in youth

Objects: The goal of this study was to investigate the differences between clinical findings in youth and in adulthood on microvascular decompression (MVD) of the facial nerve for the treatment of hemifacial spasm (HFS). Meth ods: We retrospectively evaluated 855 patients who underwent MVD from Janua ry 1985 to July 1999. In our series of 33 young HFS patients, all patients had definite offending vessels. Interestingly, pathologic tortuous vertebra l artery as a possible etiology was more rarely observed in young HFS patie nts (1/33 patients, 3.0%) than in adult patients (61/822 patients, 7.4%) (P <0.05). We did not observe any anatomical variations of the vessels or any arachnoidal thickening around the root entry zone and cerebellopontine cist ern in youths. Furthermore, young HFS patients did not necessarily have poo rer surgical outcomes than adult HFS patients. Conclusions: Our results sug gest that the cause and progress of HFS are the same in youth as in adultho od, even though the pathogenesis of early onset remains unclear.