{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T10:58:58Z","timestamp":1769252338799,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Botulinum toxin is an effective treatment for hemifacial spasm in elderly patients. However, some patients do not tolerate the side effects and frequency of botulinum toxin treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this study was to evaluate the characteristics and outcomes of a cohort of elderly patients referred by neurologists for surgical decompression of the facial nerve following botulinum toxin treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective cohort study, logistic regression was used to detect potential predictors of spasm\u2010freedom after surgical decompression of the facial nerve in elderly patients that received \u22648 and &gt;8 botulinum toxin treatments for hemifacial spasm before surgery. Age, sex, side, preoperative symptom duration, and preoperative botulinum toxin treatment were assessed as potential predictors of spasm\u2010freedom at last follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 76 elderly patients with hemifacial spasm treated with botulinum toxin and microvascular decompression, with at least 2\u2010years of follow\u2010up (median, 44.5\u2009months), 84.2% were spasm\u2010free at last follow\u2010up. Age (<jats:italic>P<\/jats:italic>\u2009=\u20090.38), sex (<jats:italic>P<\/jats:italic>\u2009=\u20090.59), side (<jats:italic>P<\/jats:italic>\u2009=\u20090.15), preoperative symptom duration (<jats:italic>P<\/jats:italic>\u2009=\u20090.7), and number of preoperative botulinum toxin treatments (<jats:italic>P<\/jats:italic>\u2009=\u20090.3) were not predictors of long\u2010term spasm\u2010freedom. Permanent ipsilateral hearing loss was the most frequent complication (3.9%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides evidence that elderly patients can undergo botulinum toxin treatment for hemifacial spasm without compromising their likelihood of achieving spasm\u2010freedom with future surgical decompression. Therefore, surgical decompression of the facial nerve is an effective therapy for elderly patients with hemifacial spasm refractory to botulinum toxin.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.14064","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T03:48:00Z","timestamp":1716436080000},"page":"966-972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Decompression Surgery in Elderly Patients with Hemifacial Spasm Refractory to Botulinum Toxin"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8107-5538","authenticated-orcid":false,"given":"Margaret","family":"Tugend","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery Columbia University Irving Medical Center, New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina M.","family":"Ulane","sequence":"additional","affiliation":[{"name":"Department of Neurology Columbia University Irving Medical Center, New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology Columbia University Irving Medical Center, New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Raymond F.","family":"Sekula","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Columbia University Irving Medical Center, New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01979049"},{"issue":"12","key":"e_1_2_7_3_1","first-page":"1108","article-title":"Hemifacial spasm, quality of life and depression","volume":"29","author":"Serrano\u2010Due\u00f1as M","year":"1999","journal-title":"Rev Neurol"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.9.JNS161022"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000266389.52843.3b"},{"key":"e_1_2_7_6_1","first-page":"443","article-title":"Hemispasme facial peripherique","volume":"8","author":"Babinski J","year":"1905","journal-title":"Rev Neurol"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2023.120587"},{"key":"e_1_2_7_8_1","unstructured":"Orphan Drug Act.97\u2010414 96 Stat. 2049;1983."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.49.7.827"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.1993.8.5.334"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.59.3.418"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000026481"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2021.106555"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1978.00500320001001"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2010.47.6.442"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23800"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000351266"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.7.891"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.8.FOCUS09142"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.JNS141699"},{"key":"e_1_2_7_21_1","first-page":"118","article-title":"Hemifacial spasm: comparison of results between patients older and younger than 70\u2009years operated on with microvascular decompression. 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