PMID- 30579277
OWN - NLM
STAT- MEDLINE
DCOM- 20200218
LR  - 20200218
IS  - 1933-0693 (Electronic)
IS  - 0022-3085 (Linking)
VI  - 131
IP  - 6
DP  - 2018 Dec 21
TI  - Facial motor evoked potential with paired transcranial magnetic stimulation: 
      prognostic value following microvascular decompression for hemifacial spasm.
PG  - 1780-1787
LID - 2018.8.JNS18708 [pii]
LID - 10.3171/2018.8.JNS18708 [doi]
AB  - OBJECTIVE: Microvascular decompression (MVD) is widely considered the treatment 
      of choice for hemifacial spasm (HFS), but not all patients immediately benefit 
      from it. Numerous electrophysiological tests have been employed to monitor the 
      integrity of the facial nerve prior to, during, and after MVD treatment. The 
      authors sought to verify if facial motor evoked potential (FMEP) with paired 
      transcranial magnetic stimulation (pTMS) can be utilized as a tool to predict 
      prognosis following MVD for HFS. METHODS: FMEP using pTMS was performed 
      preoperatively and postoperatively for 527 HFS patients who underwent an MVD 
      treatment. Various interstimuli intervals (ISIs), which included 2, 10, 20, 25, 
      30, 75, and 100 msec, were applied for each paired stimulation and pTMS(%) was 
      obtained. A graph of pTMS(%) versus each ISI was drawn for every patient and its 
      pattern was analyzed in accordance with patients' clinical outcomes. RESULTS: 
      With ISIs of 75 and 100 msec, pTMS(%) was physiologically further inhibited, 
      whereas it was relatively facilitated under ISIs of 20, 25, and 30 msec; loss of 
      this specific pattern, that is, further inhibition-relative facilitation, 
      indicated impaired integrity of the facial nerve. Those patients who immediately 
      benefited from an MVD and experienced no relapse tended to show proper 
      restoration of this further inhibition-relative facilitation pattern (p = 0.01). 
      Greater resemblance between the physiological pattern of pTMS(%) and 
      postoperative pTMS(%) was correlated to better outcome (p = 0.019). CONCLUSIONS: 
      A simple linear graph of pTMS(%) versus each ISI may be a helpful tool to predict 
      prognosis for HFS following an MVD.
FAU - Park, Jae Sung
AU  - Park JS
AD  - Departments of1Neurosurgery and.
AD  - 3Department of Neurosurgery, Konkuk University School of Medicine, Chungju, South 
      Korea.
FAU - Lee, Seunghoon
AU  - Lee S
AD  - Departments of1Neurosurgery and.
FAU - Park, Sang-Ku
AU  - Park SK
AD  - 2Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul; and.
FAU - Lee, Jeong-A
AU  - Lee JA
AD  - Departments of1Neurosurgery and.
FAU - Park, Kwan
AU  - Park K
AD  - Departments of1Neurosurgery and.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Evoked Potentials, Motor/*physiology
MH  - Facial Nerve/*physiology
MH  - Female
MH  - Hemifacial Spasm/*diagnosis/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Microvascular Decompression Surgery/*methods
MH  - Middle Aged
MH  - Prognosis
MH  - Transcranial Magnetic Stimulation/*methods
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - FMEP = facial motor evoked potential
OT  - HFS = hemifacial spasm
OT  - IFR = inhibited-facilitated ratio
OT  - ISI = interstimuli interval
OT  - LSR = lateral spread response
OT  - MEP = motor evoked potential
OT  - MVD = microvascular decompression
OT  - PPR = perioperative pTMS(%) ratio
OT  - REZ = root entry zone
OT  - TMS = transcranial magnetic stimulation
OT  - functional neurosurgery
OT  - hemifacial spasm
OT  - microvascular decompression
OT  - pTMS = paired transcranial magnetic stimulation
OT  - paired pulse
OT  - transcranial magnetic stimulation
EDAT- 2018/12/24 06:00
MHDA- 2020/02/19 06:00
CRDT- 2018/12/23 06:00
PHST- 2018/03/14 00:00 [received]
PHST- 2018/08/09 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2020/02/19 06:00 [medline]
PHST- 2018/12/23 06:00 [entrez]
AID - 2018.8.JNS18708 [pii]
AID - 10.3171/2018.8.JNS18708 [doi]
PST - ppublish
SO  - J Neurosurg. 2018 Dec 21;131(6):1780-1787. doi: 10.3171/2018.8.JNS18708.