Objective To assess the results of microvascular decompression (MVD) in treating cranial nervehyperactive dysfunction. Methods From October 2002 to January 2007, 106 patients with cranial never hyperactivedysfunction were treated with MVD. Among them, there were 47 males and 59 females with an average age of 62 years (42-85 years), including 56 cases of trigeminal neuralgia, 33 cases of hemifacial spasm and 17 cases of spasmodic torticoll is. MRI showed obvious nerve root compression in 60 patients (56.6%), suspected nerve root compression in 33 patients (31.1%) and no nerve root compression in 13 patients (12.3%). The disease course was 2-300 months with median course of 54 months. The typical manifestations before operation were pain and myospasm in corresponding innervation region. Results The superior cerebellar artery was the most common offending vessel in trigeminal neuralgia (44.6%, 25/56), the anterior inferior cerebellar artery in hemifacial spasm (33.3%, 11/33), and the vertebra-basilar artery in spasmodic torticol is (82.4%, 14/17). Compl ications of facial paralysis, hypoacusia, facial numbness, dizziness, pain of neck and shoulder, muscles weakness of neck and subcutaneous dropsy occurred in 31 patients (29.2%). All patients were followed up for 6-42 months. The total response rate was 90.6%. The curative rate of MVD was 83.9% (47/56) in trigeminal neuralgia, 81.8% (27/33) in hemifacial spasm and 41.2% (7/17) in spasmodic torticol is, respectively. Five patients failed to response (4.7%), 2 of them were cured after re-operation and 3 abandoned further treatrment. Five patients suffered recurrence 3-8 months after operation (4.7%), 2 of them recovered after re-operation, 1 got rel ief by Gamma-knife treatment, and 2 abandoned further treatment. Conclusion MVD has a good therapeutic effect on the disease caused by vascular compression of cranial nerve. Comprehensive preoperative evaluation, skillful operational technique and intraoperative electrophysiological monitoring should be implemented to enhance the therapeutic effects of MVD and to prevent possible compl ications.
目的:探讨显微血管减压术治疗面肌痉挛的手术方法和效果。方法:34例面肌痉挛患者行显微血管减压术,记录手术效果和并发症,出院后进行电话随访1～2年。结果:27例患者术后面肌痉挛完全停止;4例1月内逐渐停止;其余3例明显减轻,无面肌痉挛复发者,无脑脊液漏。术后随访1～6年,远期并发症有轻度面瘫2例,轻度听力下降1例。结论:显微血管减压术治疗面肌痉挛要注意责任血管的准确辨认和采用适当的手术方法,治愈率高、创伤小,远期并发症少。
目的:观察A型肉毒毒素(BTXA)对面肌痉挛(HFS)患者痉挛程度的改善和生存质量的影响。方法: 对68例HFS患者进行局部注射BTXA,治疗前及治疗后1个月分别对患者的痉挛程度进行判定和使用世界卫生组织生存质量评定量表简表(WHOQOL-BREF)评价生存质量。 结果: 97.04%的HFS患者在BXTA治疗后1个月痉挛明显改善缓解,而且患者在WHOQOL-BREF的生理领域、心理领域、社会关系领域、总的健康状况和总的生存质量的评分均明显高于治疗前,差异有统计学意义(Plt;0.01)。 结论: 局部注射BTXA可迅速缓解或消除HFS患者肌肉痉挛,提高患者的生存质量。
ObjectiveTo explore the clinical effect of kinesio-taping therapy on hemifacial spasm.MethodsPatients with hemifacial spasm in the Rehabilitation Medical Center of West China Hospital, Sichuan University from June 2015 to December 2018 were included. They were randomly divided into the kinesio-taping group and control group. The patients in the control group underwent ultrashort wave therapy and facial muscle function training: once a day, 10 days as a course of treatment; 2 days rest between each course; a total of 3 courses of treatment. In the kinesio-taping group, besides the original treatment, the kinesio-taping therapy was added: once a day, 10 times as a course of treatment; 2 days rest between each course; a total of 3 courses of treatment. The clinical effect of the two groups was observed.ResultsA total of 60 patients were included, with 30 in each of the two groups. There was no significant difference in the classification of facial muscle spasm between the two groups before the treatment (Z=−0.233, P=0.816). After the treatment, the difference in the classification of facial muscle spasm between the two groups was statistically significant (Z=−3.062, P=0.002); while both the kinesio-taping group (Z=−4.688, P< 0.001) and the control group (Z=−3.804, P< 0.001) improved compared with those before the treatment. The effect of kinesio-taping group [93.33% (28/30)] was better than that of the control group [76.67% (23/30)] (Z=−3.073, P=0.002).ConclusionKinesio-taping therapy can relieve the stiffness and pain caused by facial spasm, promote the recovery of facial muscle sensory function and bilateral coordinated movement, and relieve the clinical symptoms of patients,with the advantages of simple operation and good effect.