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. 2024 Jun 15;166(1):268.
doi: 10.1007/s00701-024-06149-0.

Radiofrequency thermocoagulation as a treatment for hemifacial spasm: long-term follow-up and management of recurrences

Paula Palomäki  1 , Tiina Sairanen  2   3 , Mika Niemelä  2   4 , Johan Marjamaa  2   4
Affiliations

Radiofrequency thermocoagulation as a treatment for hemifacial spasm: long-term follow-up and management of recurrences

Paula Palomäki et al. Acta Neurochir (Wien). .

Abstract

Background: Radiofrequency thermocoagulation (RFT) is a treatment used to relieve symptoms of cranial nerve disorders. The current study is the first to describe the results of hemifacial spasm (HFS) patients with a history of repeated RFT in the second-largest consecutive single-center patient series with long-term follow-up.

Method: This retrospective study was conducted in the largest hospital district in Finland (Helsinki and Uusimaa). Consecutive HFS patients who had an RFT to treat HFS in the Hospital District of Helsinki and Uusimaa between 2009-2020 were included.

Results: Eighteen patients with 53 RFTs were identified from the medical records. 11 (61 %) patients had repeated RFTs, and the mean number of RFTs per patient was 3.33 (3.29 SD). The mean follow-up was 5.54 years (7.5 SD). 12 (67 %) patients had had microvascular decompression (MVD) before RFT. Patients were satisfied with the results after 87 % of RFTs. Relief of the twitching of the face lasted 11.27 months (11.94 SD). All patients had postoperatively transient facial paresis. Postoperative paresis lasted a mean of 6.47 months (6.80 SD). The depth of paresis was postoperatively typically moderate (36.54 %, House Brackmann III). 23.08 % had mild paresis (House-Brackmann II), 23.08 % had moderately severe dysfunction (House-Brackmann IV), 9.62 % had severe dysfunction, and 7.69 % had total paralysis of the facial muscles (House-Brackmann VI). Duration of relief in the face twitching (p 0.002) and temperature at the final coagulation point (p 0.004) were statistically significant predictors of satisfaction with the RFT results.

Conclusions: RFT can be used to treat recurrences of HFS repeatedly. It provides symptom relief for around 11 months, lasting four times longer than with botulinum toxin injections. Patients are satisfied, although an RFT produces transient, sometimes even severe, facial paresis.

Keywords: Hemifacial spasm; Paresis; Radiofrequency thermocoagulation; Recurrence.

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Conflict of interest statement

This article will be included in author Paula Palomäki’s thesis. The other authors of this article have no further non-financial interest in this article.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves represent the percentage of hemifacial spasm patients gaining relief from the twitching of the face and having paresis after radiofrequency thermocoagulation treatment of the facial nerve. This figure was created by using Inkscape
See this image and copyright information in PMC

Comment in

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