面部诱发肌电图监测在面肌痉挛显微血管减压治疗中的临床价值

目的:探讨面部诱发肌电图在面肌痉挛显微血管减压术中的应用价值.方法:对68例面肌痉挛患者实施显微血管减压术,分别在术前、术中、术后进行面部诱发肌电图监测,刺激痉挛侧(手术侧)面神经下颌缘支,记录同侧眼轮匝肌肌电位.结果:术前68例均在痉挛侧记录到异常肌电图(MD-OC反应);术中监测60例在不同阶段MD-OC反应消失,另有8例MD-OC反应未消失;术后随访67例痉挛症状消失,1例MD-OC反应及痉挛症状持续存在.结论:在面肌痉挛显微血管减压治疗中应用面部诱发肌电图监测,对术中实时减压效果判断和预后估计具有重要指导意义.

Clinical value of monitoring facial electromyographic responses during microvascular decompression for hemifacial spasm

Objective: To study the clinical value of monitoring facial electromyographic (EMG) responses during microvascular decompression for hemifacial spasm(HFS).Methods:Facial EMG responses were monitored pre-operatively and post-operatively and during microvascular decompression of 68 patients with HFS.The stimulating electrodes were inserted over the mentalis muscle,while evoked facial EMG responses were monitored in orbicularis oculi.Results:Abnormal EMG responses(MD-OC)were recorded pre-operatively in all 68 patients.In 60 patients,the MD-OC disappeared at different stages of procedure from dural opening through vascular mobilization.Those patients were free of spasm at 6-month follow-up. 7 out of 8 patients in whom the MD-OC was recorded even at the end of operation were also clinically cured at the 6-month follow-up visit,whereas spasm persisted in 1 patient.Conclusion:This stndy demonstrates monitoring facial EMG responses is useful in estimating efficacy of decompression and helpful in predicting prognosis in hemifacial spasm.