[2007.5.31] Treatment guidelines for Korean forms of diseases should be developed in Korea

Samsung Medical Center Department of Neurosurgery Facial Spasm Clinic;
Development of a treatment guideline for hemifacial spasm and research presentation

Presently, Korea’s treatments for Brain Tumor and Cerebrovascular diseases have reached international level and are expected to develop even further. However, diseases that are known to occur more commonly in Easterners than Westerners such as the moyamoya disease and hemifacial spasm are still being researched, including the cause and the risk factors. Since the diseases are rare in the case of Westerners, the interest in the research is lower than most other neurosurgical diseases, and is in need of interest and research from domestic doctors in this country.

In response, Professor Park’s team from Samsung Medical Center facial spasm and trigeminal neuralgia clinic prepared the latest treatment guidelines and a classification system for hemifacial spasm, the disease that is common in easterners and especially Koreans. They presented them to the U.S. neurosurgery society and the European neurosurgery society and received large support.

Samsung Medical Center facial spasm and trigeminal neuralgia clinic led by Professor Park analyzed the data collected from approximately 800 facial spasm patients that were treated from its opening in 1995 to the present 2007 and created a new chapter in the treatment of facial spasm by preparing a classification system of the cause of facial spasm and a standard treatment guideline for it. Most notably the research team has published theses to numerous neurosurgery societies and even SCI registered journals on the accumulated methods of surgery after the treatment of numerous patients, the usefulness of intraoperative monitoring of neurophysiology, and the indication and time of requiring surgery again, aftereffects that can occur after surgery, and overall prognosis. (1. Kong DS, Lee JA, Park K. Prognostic value of the lateral spread response for intraoperative electromyography monitoring of the facial musculature during microvascular decompression for hemifacial spasm. J Neurosurg. 2007 Mar, 2. Park JS, Kong DS, Park K. Intraoperative management to prevent cerebrospinal fluid leakage after microvascular decompression: dural closure with a "plugging muscle" method. Neurosurg Rev. 2007 Apr, 3. Rhee DJ, Kong DS, Park K. Frequency and prognosis of delayed facial palsy after microvascular decompression for hemifacial spasm. Acta Neurochir (Wien). 2006 Aug). Also, being recognized for the extensive experience in research publications, they presented ‘Chronologic analysis of symptomatic change following microvascular decompression for hemifacial spasm: Value for predicting long-term outcome’ and ‘Intraoperative findings of hemifacial spasm: The pattern of neurovascular compression’ to the Association of American Neurological Surgeons in April 2007. This became an opportunity to inform the world that Korea is independently researching on the reason why this disease is more common in Easterners, the classification, and the treatment for this disease.

 

Hemifacial spasm, which is most common in adults from 40~50, has 3000 new cases every year in Korea. This is about 4 to 5 times the amount that the Westerners experience. However, many patients have misconceptions about the disease and use traditional oriental treatments or folk remedies that have been known to be ineffective. This often results in treatment well after the optimal time for treating the disease.

Samsung Medical Center Neurosurgery Facial Spasm Clinic is currently using the already published clinical research and the outcome in its diagnosis and treatment. It makes it possible to verify the success of the surgery using intraoperative monitoring of neurophysiology and this can reduce the time of hospitalization to less than 5 days. Even with the short time spent in the hospital, it shows a 90% or better success rate than hospitals in the U.S. and Europe. The clinic is putting much effort into continually doing in-depth research on facial spasm and trigeminal neuralgia and to develop and improve the treatment guidelines for the diseases.