{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T02:23:02Z","timestamp":1781576582858,"version":"3.54.5"},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2013,3]]},"abstract":"\n Object<\/jats:title>\n The objective of this study was to investigate the clinical characteristics, intraoperative findings, complications, and outcomes after the first microvascular decompression (MVD) in patients with and without previous botulinum neurotoxin treatment for hemifacial spasm (HFS).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The authors analyzed 246 MVDs performed at the University of Pittsburgh Medical Center between January 1, 2000, and December 31, 2007. One hundred and seventy-six patients with HFS underwent botulinum neurotoxin injection treatment prior to first MVD (Group I), and 70 patients underwent their first MVD without previous botulinum neurotoxin treatment (Group II). Clinical outcome data were obtained immediately after the operation, at discharge, and at follow-up. Follow-up data were collected from 177 patients with a minimum follow-up period of 9 months (mean 54.48 \u00b1 27.84 months).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In 246 patients, 89.4% experienced immediate postoperative relief of spasm, 91.1% experienced relief at discharge, and 92.7% experienced relief at follow-up. There was no significant difference in outcomes and complications between Group I and Group II (p > 0.05). Preoperatively, patients in Group I had higher rates of facial weakness, tinnitus, tonus, and platysmal involvement as compared with Group II (p < 0.05). The posterior inferior cerebellar artery and vertebral artery were intraoperatively identified as the offending vessels in cases of vasculature compression in a significantly greater number of patients in Group II compared with Group I (p = 0.008 and p = 0.005, respectively, for each vessel). The lateral spread response (LSR) disappeared in 60.48% of the patients in Group I as compared with 74.19% in Group II (p > 0.05). No significant differences in complications were noted between the 2 groups.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Microvascular decompression is an effective and safe procedure for patients with HFS previously treated using botulinum neurotoxin. Intraoperative monitoring with LSR is an effective tool for evaluating adequate decompression.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2012.11.focus12373","type":"journal-article","created":{"date-parts":[[2013,3,2]],"date-time":"2013-03-02T01:05:30Z","timestamp":1362186330000},"page":"E3","source":"Crossref","is-referenced-by-count":26,"title":["Effect of previous botulinum neurotoxin treatment on microvascular decompression for hemifacial spasm"],"prefix":"10.3171","volume":"34","author":[{"given":"Xuhui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parthasarathy D.","family":"Thirumala","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Neurology, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aalap","family":"Shah","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gardner","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Habeych","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald J.","family":"Crammond","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Balzer","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0340003","series-title":"Stereotact Funct Neurosurg","first-page":"260","article-title":"Microvascular decompression for the treatment of hemifacial spasm. Retrospective study of a consecutive series of 75 operated patients\u2014electrophysiologic and anatomical surgical analysis","volume":"68","author":"Acevedo","year":"1997"},{"key":"b2-0340003","series-title":"Arq Neuropsiquiatr","first-page":"502","article-title":"Botulinum toxin type A in the treatment of hemifacial spasm: an 11-year experience","volume":"68","author":"Barbosa","year":"2010"},{"key":"b3-0340003","series-title":"Eur J Neurol","first-page":"392","article-title":"Outcome predictors, efficacy and safety of Botox and Dysport in the long-term treatment of hemifacial spasm","volume":"16","author":"Bentivoglio","year":"2009"},{"key":"b4-0340003","series-title":"J Neurosurg","first-page":"416","article-title":"Neurovascular compression findings in hemifacial spasm","volume":"109","author":"Campos-Benitez","year":"2008"},{"key":"b5-0340003","series-title":"Childs Nerv Syst","first-page":"309","article-title":"Microvascular decompression of the facial nerve for hemifacial spasm in youth","volume":"17","author":"Chang","year":"2001"},{"key":"b6-0340003","series-title":"Stereotact Funct Neurosurg","first-page":"190","article-title":"Microvascular decompression for hemifacial spasm: a long-term follow-up of 1,169 consecutive cases","volume":"77","author":"Chung","year":"2001"},{"key":"b7-0340003","series-title":"Eye (Lond)","first-page":"600","article-title":"Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes","volume":"24","author":"Cillino","year":"2010"},{"issue":"1","key":"b8-0340003","series-title":"Cochrane Database Syst Rev","first-page":"CD004899","article-title":"Botulinum toxin type A therapy for hemifacial spasm","author":"Costa","year":"2005"},{"key":"b9-0340003","series-title":"J Neurosurg","first-page":"410","article-title":"Microvascular decompression for hemifacial spasm: long-term results from 114 operations performed without neurophysiological monitoring","volume":"109","author":"Dannenbaum","year":"2008"},{"key":"b10-0340003","series-title":"Clin Neurophysiol","first-page":"78","article-title":"Intra-operative neurophysiology during microvascular decompression for hemifacial spasm","volume":"123","author":"Fern\u00e1ndez-Conejero","year":"2012"},{"key":"b11-0340003","series-title":"Can J Neurol Sci","first-page":"631","article-title":"Long-term efficacy of botulinum a toxin for blepharospasm and hemifacial spasm","volume":"37","author":"Gill","year":"2010"},{"key":"b12-0340003","series-title":"Muscle Nerve","first-page":"518","article-title":"Effect of botulinum neurotoxin treatment in the lateral spread monitoring of microvascular decompression for hemifacial spasm","volume":"44","author":"Habeych","year":"2011"},{"key":"b13-0340003","series-title":"Clin Neurosurg","first-page":"331","article-title":"Outcome after microvascular decompression for typical trigeminal neuralgia, hemifacial spasm, tinnitus, disabling positional vertigo, and glossopharyngeal neuralgia (honored guest lecture)","volume":"44","author":"Jannetta","year":"1997"},{"key":"b14-0340003","series-title":"Neurosurgery","first-page":"1251","article-title":"Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes","volume":"52","author":"Kalkanis","year":"2003"},{"key":"b15-0340003","series-title":"J Neurosurg","first-page":"384","article-title":"Prognostic value of the lateral spread response for intraoperative electromyography monitoring of the facial musculature during microvascular decompression for hemifacial spasm","volume":"106","author":"Kong","year":"2007"},{"key":"b16-0340003","series-title":"Neurol Res","first-page":"727","article-title":"Vascular compression of cranial nerves. I. History of the microvascular decompression operation","volume":"20","author":"M\u00f8ller","year":"1998"},{"key":"b17-0340003","series-title":"Neurosurgery","first-page":"612","article-title":"Microvascular decompression in hemifacial spasm: intraoperative electrophysiological observations","volume":"16","author":"M\u00f8ller","year":"1985"},{"key":"b18-0340003","series-title":"J Neurosurg","first-page":"681","article-title":"Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm","volume":"66","author":"M\u00f8ller","year":"1987"},{"key":"b19-0340003","series-title":"Prog Brain Res","first-page":"397","article-title":"Microvascular decompression operations","volume":"166","author":"M\u00f8ller","year":"2007"},{"key":"b20-0340003","series-title":"J Med Liban","first-page":"146","article-title":"[Microsurgical facial nerve decompression for hemifacial spasm.]","volume":"54","author":"Moussa","year":"2006"},{"key":"b21-0340003","series-title":"Cir Cir","first-page":"5","article-title":"[Microvascular decompression for hemifacial spasm. Ten years of experience.]","volume":"71","author":"Revuelta-Guti\u00e9rrez","year":"2003"},{"key":"b22-0340003","series-title":"Neurosurgery","first-page":"712","article-title":"Microvascular decompression to treat hemifacial spasm: long-term results for a consecutive series of 143 patients","volume":"50","author":"Samii","year":"2002"},{"key":"b23-0340003","series-title":"Clin Neurol Neurosurg","first-page":"673","article-title":"Hearing outcomes following microvascular decompression for hemifacial spasm","volume":"114","author":"Shah","year":"2012"},{"key":"b24-0340003","series-title":"Neurochirurgie","first-page":"17","article-title":"[Microsurgical vascular decompression in the treatment of facial hemispasm. A retrospective study of a series of 65 cases and review of the literature.]","volume":"42","author":"Sindou","year":"1996"},{"key":"b25-0340003","series-title":"Acta Neurochir (Wien)","first-page":"1019","article-title":"Microvascular decompression for primary hemifacial spasm. Importance of intraoperative neurophysiological monitoring","volume":"147","author":"Sindou","year":"2005"},{"issue":"1 Suppl Operative","key":"b26-0340003","series-title":"Neurosurgery","first-page":"ons64","article-title":"Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes","volume":"69","author":"Thirumala","year":"2011"},{"key":"b27-0340003","series-title":"J Clin Neurophysiol","first-page":"56","article-title":"Microvascular decompression for hemifacial spasm: evaluating outcome prognosticators including the value of intraoperative lateral spread response monitoring and clinical characteristics in 293 patients","volume":"28","author":"Thirumala","year":"2011"},{"key":"b28-0340003","series-title":"Acta Neurochir (Wien)","first-page":"933","article-title":"Abnormal muscle response monitoring during microvascular decompression for hemifacial spasm","volume":"147","author":"Yamashita","year":"2005"},{"key":"b29-0340003","series-title":"Clin Neurol Neurosurg","first-page":"846","article-title":"A clinical analysis on microvascular decompression surgery in a series of 3000 cases","volume":"114","author":"Zhong","year":"2012"},{"key":"b30-0340003","series-title":"Acta Neurochir (Wien)","first-page":"2119","article-title":"An analysis of failed microvascular decompression in patients with hemifacial spasm: focused on the early reoperative findings","volume":"152","author":"Zhong","year":"2010"},{"key":"b1-0340003","series-title":"Stereotact Funct Neurosurg","first-page":"260","article-title":"Microvascular decompression for the treatment of hemifacial spasm. Retrospective study of a consecutive series of 75 operated patients\u2014electrophysiologic and anatomical surgical analysis","volume":"68","author":"Acevedo","year":"1997"},{"key":"b2-0340003","series-title":"Arq Neuropsiquiatr","first-page":"502","article-title":"Botulinum toxin type A in the treatment of hemifacial spasm: an 11-year experience","volume":"68","author":"Barbosa","year":"2010"},{"key":"b3-0340003","series-title":"Eur J Neurol","first-page":"392","article-title":"Outcome predictors, efficacy and safety of Botox and Dysport in the long-term treatment of hemifacial spasm","volume":"16","author":"Bentivoglio","year":"2009"},{"key":"b4-0340003","series-title":"J Neurosurg","first-page":"416","article-title":"Neurovascular compression findings in hemifacial spasm","volume":"109","author":"Campos-Benitez","year":"2008"},{"key":"b5-0340003","series-title":"Childs Nerv Syst","first-page":"309","article-title":"Microvascular decompression of the facial nerve for hemifacial spasm in youth","volume":"17","author":"Chang","year":"2001"},{"key":"b6-0340003","series-title":"Stereotact Funct Neurosurg","first-page":"190","article-title":"Microvascular decompression for hemifacial spasm: a long-term follow-up of 1,169 consecutive cases","volume":"77","author":"Chung","year":"2001"},{"key":"b7-0340003","series-title":"Eye (Lond)","first-page":"600","article-title":"Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes","volume":"24","author":"Cillino","year":"2010"},{"issue":"1","key":"b8-0340003","series-title":"Cochrane Database Syst Rev","first-page":"CD004899","article-title":"Botulinum toxin type A therapy for hemifacial spasm","author":"Costa","year":"2005"},{"key":"b9-0340003","series-title":"J Neurosurg","first-page":"410","article-title":"Microvascular decompression for hemifacial spasm: long-term results from 114 operations performed without neurophysiological monitoring","volume":"109","author":"Dannenbaum","year":"2008"},{"key":"b10-0340003","series-title":"Clin Neurophysiol","first-page":"78","article-title":"Intra-operative neurophysiology during microvascular decompression for hemifacial spasm","volume":"123","author":"Fern\u00e1ndez-Conejero","year":"2012"},{"key":"b11-0340003","series-title":"Can J Neurol Sci","first-page":"631","article-title":"Long-term efficacy of botulinum a toxin for blepharospasm and hemifacial spasm","volume":"37","author":"Gill","year":"2010"},{"key":"b12-0340003","series-title":"Muscle Nerve","first-page":"518","article-title":"Effect of botulinum neurotoxin treatment in the lateral spread monitoring of microvascular decompression for hemifacial spasm","volume":"44","author":"Habeych","year":"2011"},{"key":"b13-0340003","series-title":"Clin Neurosurg","first-page":"331","article-title":"Outcome after microvascular decompression for typical trigeminal neuralgia, hemifacial spasm, tinnitus, disabling positional vertigo, and glossopharyngeal neuralgia (honored guest lecture)","volume":"44","author":"Jannetta","year":"1997"},{"key":"b14-0340003","series-title":"Neurosurgery","first-page":"1251","article-title":"Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes","volume":"52","author":"Kalkanis","year":"2003"},{"key":"b15-0340003","series-title":"J Neurosurg","first-page":"384","article-title":"Prognostic value of the lateral spread response for intraoperative electromyography monitoring of the facial musculature during microvascular decompression for hemifacial spasm","volume":"106","author":"Kong","year":"2007"},{"key":"b16-0340003","series-title":"Neurol Res","first-page":"727","article-title":"Vascular compression of cranial nerves. I. History of the microvascular decompression operation","volume":"20","author":"M\u00f8ller","year":"1998"},{"key":"b17-0340003","series-title":"Neurosurgery","first-page":"612","article-title":"Microvascular decompression in hemifacial spasm: intraoperative electrophysiological observations","volume":"16","author":"M\u00f8ller","year":"1985"},{"key":"b18-0340003","series-title":"J Neurosurg","first-page":"681","article-title":"Monitoring facial EMG responses during microvascular decompression operations for hemifacial spasm","volume":"66","author":"M\u00f8ller","year":"1987"},{"key":"b19-0340003","series-title":"Prog Brain Res","first-page":"397","article-title":"Microvascular decompression operations","volume":"166","author":"M\u00f8ller","year":"2007"},{"key":"b20-0340003","series-title":"J Med Liban","first-page":"146","article-title":"[Microsurgical facial nerve decompression for hemifacial spasm.]","volume":"54","author":"Moussa","year":"2006"},{"key":"b21-0340003","series-title":"Cir Cir","first-page":"5","article-title":"[Microvascular decompression for hemifacial spasm. Ten years of experience.]","volume":"71","author":"Revuelta-Guti\u00e9rrez","year":"2003"},{"key":"b22-0340003","series-title":"Neurosurgery","first-page":"712","article-title":"Microvascular decompression to treat hemifacial spasm: long-term results for a consecutive series of 143 patients","volume":"50","author":"Samii","year":"2002"},{"key":"b23-0340003","series-title":"Clin Neurol Neurosurg","first-page":"673","article-title":"Hearing outcomes following microvascular decompression for hemifacial spasm","volume":"114","author":"Shah","year":"2012"},{"key":"b24-0340003","series-title":"Neurochirurgie","first-page":"17","article-title":"[Microsurgical vascular decompression in the treatment of facial hemispasm. A retrospective study of a series of 65 cases and review of the literature.]","volume":"42","author":"Sindou","year":"1996"},{"key":"b25-0340003","series-title":"Acta Neurochir (Wien)","first-page":"1019","article-title":"Microvascular decompression for primary hemifacial spasm. Importance of intraoperative neurophysiological monitoring","volume":"147","author":"Sindou","year":"2005"},{"issue":"1 Suppl Operative","key":"b26-0340003","series-title":"Neurosurgery","first-page":"ons64","article-title":"Somatosensory evoked potential monitoring during endoscopic endonasal approach to skull base surgery: analysis of observed changes","volume":"69","author":"Thirumala","year":"2011"},{"key":"b27-0340003","series-title":"J Clin Neurophysiol","first-page":"56","article-title":"Microvascular decompression for hemifacial spasm: evaluating outcome prognosticators including the value of intraoperative lateral spread response monitoring and clinical characteristics in 293 patients","volume":"28","author":"Thirumala","year":"2011"},{"key":"b28-0340003","series-title":"Acta Neurochir (Wien)","first-page":"933","article-title":"Abnormal muscle response monitoring during microvascular decompression for hemifacial spasm","volume":"147","author":"Yamashita","year":"2005"},{"key":"b29-0340003","series-title":"Clin Neurol Neurosurg","first-page":"846","article-title":"A clinical analysis on microvascular decompression surgery in a series of 3000 cases","volume":"114","author":"Zhong","year":"2012"},{"key":"b30-0340003","series-title":"Acta Neurochir (Wien)","first-page":"2119","article-title":"An analysis of failed microvascular decompression in patients with hemifacial spasm: focused on the early reoperative findings","volume":"152","author":"Zhong","year":"2010"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/34\/3\/article-pE3.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/34\/3\/article-pE3.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/34\/3\/article-pE3.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:22:47Z","timestamp":1780734167000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/34\/3\/article-pE3.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3]]},"references-count":60,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2012.11.focus12373","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3]]}}}