Title: Microvascular Decompression for Primary Hemifacial Spam
Dr. Antonio Daher Ramos is the Medical Doctor graduated from the University of Carabobo. Valencia, Venezuela 1982. He has received a National Award of Neurosurgery at Venezuela in the Year 2004. He is the Member of the French Neurosurgical Society. Member of the French Speaking Neurosurgical Society. Member of the North American Skull Base Society. Member of the Latin American Federation of Neurosurgery. Member of the Inter-American Society of Minimal Invasive Spinal Surgery (SICCMI). Member of the Venezuelan Neurosurgical Society. Member of the Latin American Society of Functional and Stereotaxic Neurosurgery (SLANFE). He has done his Fellow resident in the Service of Professor Gazi Yasargil. Zurich, 1987.Numerous works of him is being published in national and international journals.
Hemifacial spasm is a rare disease characterized by involuntary muscle contractions in one side of the face; it has an incidence of less than 1 in 100,000 people. It consists of a progressive, spontaneous and intermittent appearance of contractions of the muscles involved in facial expression.
Hemifacial spasm has an important psychological and cosmetic effect in patients; in advanced cases, vision may also be affected. In our experience, primary hemifacial spasm is a disease that usually begins between 41 and 60 years with an average of 50 years.
However, different literature series suggests that the age of appearance can vary between 18 and 77 years. Most patients are female with an incidence of 2.4 women over men. The most affected side of the face is the left side. It has been suggested that the predominance of the left side may be due to a predisposition of the embryological position in relation to the facial nerve compression and the compressed vessel in the entry zone of the nerve on the left side. The nerve compression at the brainstem is almost always seen on magnetic resonance imaging (MRI).
Bilateral hemifacial spasm is very rare.
The definitive treatment is Microvascular Decompression (MVD) of the facial nerve in the cerebello-pontine angle, which cures the disease in 80 to 90% of patients.