Microvascular Decompressive Surgery for Hemifacial Spasm

Status Not yet recruiting

Clinical Trial Summary

- Review the clinical outcomes of Micro vascular decompression of Hemi facial Spasm.

- Assess safety and efficacy of Micro vascular decompression.

- Improve the outcome of these patients and decease rate of recurrence and complications.

Clinical Trial Description

Hemi facial spasm (HFS), a term described in 1905 by Babinski but first reported by Schultz in 1875, is a highly morbid movement disorder characterized by intermittent involuntary movement of muscles innervated by the facial nerve.

(HFS) affects roughly 10 in 100,000 individuals in fifth or sixth decades of life.

Primary HFS is commonly attributed to vascular loops compressing the seventh cranial nerve at its exit zone from the brainstem. The facial nerve compression is thought to lead to ephaptic transmission and to hyperactivity of the facial nucleus, resulting in the involuntary facial movements.

Secondary HFS frequently follows peripheral facial palsy or may arise from facial nerve damage produced by tumours, demyelinating disorders, traumatisms, and infections accounting for 1-2 & of HFS.

Over four in five primary HFS cases involve either anterior or posterior inferior cerebellar artery as the primary offender although vertebral artery, multiple vessels and veins may be involved.

EMG recordings confirm the diagnosis by showing a typical electrophysiological signature: clonic facial muscle contractions, hyperactivity, and synkinesis, lateral spread evoked responses.

Imaging can be useful for confirming that HFS is primary in nature and due to a neurovascular compression. In most cases (95% of the patients) the compressive vessel, generally an artery, is seen on MRI combined with MR-Angiography (MRA). High resolution T2-sequence is to be used to get good delineation of the facial nerve.

Many treatments for HFS have been reported, including pharmacological agents, botulinum toxin injection, facial nerve blockage, physical therapy, radiofrequency ablation, acupuncture, as well as facial nerve combing and microvascular decompression (MVD).

However, while MVD is effective, there are still significant postoperative complications. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT04474977
Study type	Observational
Source	Assiut University
Contact
Status	Not yet recruiting
Phase
Start date	September 1, 2020
Completion date	March 1, 2023

View Details

See also
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Completed	`NCT05103202` - Efficacy and Safety of 10-Week or Shorter vs 12-Week or Longer Injection Intervals of Botulinum Toxin
Unknown status	`NCT01726725` - Hemifacial Spasm and Desflurane	N/A
Completed	`NCT01598961` - Determination of Target of Adequate Partial Neuromuscular Blockade for Electrophysiologic Monitoring During Microvascular Decompression Surgery	N/A
Not yet recruiting	`NCT04589364` - Study of Abobotulinum Toxin Versus Neubotulinum Toxin Injection For Hemifacial Spasm in Thai Patients	Phase 3
Completed	`NCT01613781` - Determination of Target of Adequate Partial Neuromuscular Blockade for Electrophysiologic Monitoring During Microvascular Decompression Surgery	N/A
Not yet recruiting	`NCT06195241` - Effects of DaxibotulinumtoxinA for Blepharospasm and Hemifacial Spasm	Phase 4
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Enrolling by invitation	`NCT01271634` - Observe Abnormal Potential From the Offending Vessel to the Facial Muscles of HFS Patients	N/A
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Completed	`NCT01728428` - A Multicenter, Observational Study to Evaluate Clinical Manifestation, Diagnosis and Treatment of Primary Hemifacial Spasm in Chinese Patients	N/A
Completed	`NCT04621578` - Transcutaneous Electrical Acupoint Stimulation on Postoperative Dizziness in Hemifacial Spasm Patients	N/A
Completed	`NCT00276315` - Assessment of Effectiveness and Safety of Dysport® for the Treatment of Hemifacial Spasm	Phase 3
Completed	`NCT02761096` - Effect of Acupuncture on Inflammation and Immune Function After Craniotomy	N/A
Unknown status	`NCT01564979` - Effect on Tear Functions of Pretarsal and Preseptal Techniques of Botulinum Toxin Type A Injection in Hemifacial Spasm	Phase 2
Not yet recruiting	`NCT01546805` - Testing the Effect of Zinc Supplementation to Improve the Treatment Effect of Botulinum Toxin for Oculofacial Spasm	N/A
Completed	`NCT01168388` - Movement Disorder Survey in East China	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.