The mechanism of hemifacial spasm: a new understanding of the offending artery

Authors:
  • NDNing-Ning Dou
    Ning-Ning Dou
  • JZJun Zhong
    Jun Zhong
  • QZQiu-Meng Zhou
    Qiu-Meng Zhou
  • JZJin Zhu
    Jin Zhu
  • YWYong-Nan Wang
    Yong-Nan Wang
  • LXLei Xia
    Lei Xia
  • XYXiao-Sheng Yang
    Xiao-Sheng Yang
  • TYTing-Ting Ying
    Ting-Ting Ying
  • XZXue-Sheng Zheng
    Xue-Sheng Zheng
  • SLShi-Ting Li
    Shi-Ting Li
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Abstract
Although neurovascular confliction was believed to be the cause of hemifacial spasm (HFS), the mechanism of the disorder remains unclear to date. Current theories, merely focusing on the facial nerve, have failed to explain the clinical phenomenon of immediate relief following a successful microvascular decompression surgery (MVD). With the experience of thousands of microvascular decompression surgeries and preliminary investigations, we have learned that the offending artery may play a more important role than the effect of merely mechanical compression in the pathogenesis of the disease. We believe that the attrition of neurovascular interface is the essence of the etiology, and the substance of the disease is emersion of ectopic action potentials from the demyelinated facial nerve fibers, which were triggered by the sympathetic endings from the offending artery wall. In this paper, we put forward evidence to support this hypothesis, both logically and theoretically.

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