Introduction: To evaluate background factors of hemifacial spasm (HFS) and trigeminal neuralgia (TN) in patients with ages less than or equal to 30 years.
Methods: From 1996 to 2012, we treated 227 patients with HFS and 190 patients with TN by microvascular decompression (MVD) at a single institute. Of these, we experienced 7 patients (6 with HFS and 1 with TN) who were 30 years or younger at the time of surgery. Assessments were based on clinical history, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), surgical findings and follow-up records.
Results: Earliest onset of vascular compression symptoms was at the age of 11 years in a patient with HFS. 6 out of 7 cases had various kinds of vascular variations on preoperative evaluation.
One patient with HFS had compression at a distal portion of the nerve. Single case of TN among 7 cases was found to have arachnoid thickening intraoperatively. Surgical outcomes with mean follow up duration of 29.71 months in young HFS patients were comparable with elder HFS patients.
Conclusions: Even though the pathogenesis of early onset of HFS and TN remains unclear, our data suggest that vascular variations may have some role. MVD seems a useful treatment tool for neurovascular compression symptoms in younger patients also.
Patient Care: This research demostrats that vascular variations may be one of the contributing factors for nerve compression in younger patients. Distal compression or deformation of nerves can be responsible for compression symptoms in younger population. These findings will be helpful in preoperative planing and good outcomes in younger patients.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Understand the importance of vascular variation and imaging studies in microvascular compression, 2) Discuss the baseline studies of 417 patients along with the findings and outcomes of microvascular decompression in patients younger than 30, 3) Understand that microvascular decompression is effective treatment even in younger patients.