Patients travel to Los Angeles for hemifacial spasm surgery

Patients with hemifacial spasm are increasingly seeking microvascular decompression in Los Angeles, where neurosurgeon Dr. Aaron Cohen-Gadol has performed more than 600 procedures. The surgery can address the underlying cause of the condition and may offer lasting relief, while Botox typically requires repeat treatment.

Why it matters: - Hemifacial spasm can persist for years and disrupt speech, vision and daily life. - Microvascular decompression targets the blood vessel compression that usually causes the condition. - Patients seeking a durable option are traveling to Los Angeles for evaluation and surgery. - The issue is not only symptom control. It is whether patients are told about a potential surgical cure early enough.

What happened: - Dr. Aaron Cohen-Gadol, a Los Angeles neurosurgeon, has performed more than 600 microvascular decompression procedures for hemifacial spasm and trigeminal neuralgia. - Patients from across the U.S. and other countries are traveling to see Dr. Cohen-Gadol for this procedure. - Dr. Cohen-Gadol performs surgeries at Cedars-Sinai Medical Center and Saint John’s Health Center in Los Angeles. - The practice also offers in-person and virtual second-opinion consultations.

The details: - Hemifacial spasm is involuntary, repetitive twitching of muscles on one side of the face. - In most cases, a blood vessel pulses against the facial nerve as it exits the brainstem. - Botox and medication do not fix the compression. They only reduce muscle activity. - Botox typically wears off within three to six months, which means repeat injections are needed. - Long-term Botox use can lead to facial weakness and cosmetic asymmetry. - Microvascular decompression moves the compressing vessel away from the facial nerve and places a cushion between them. - More than 80% of appropriately selected patients achieve complete, lasting relief after surgery. - Many patients improve within days to weeks, and the results can last for years. - At experienced centers, temporary facial weakness occurs in a small minority of patients and usually resolves. - Serious complications are uncommon. - Most patients spend a few days in the hospital and return to non-strenuous activity within one to two weeks. - Dr. Cohen-Gadol said the main risk comes from inexperience, not the operation itself. - "I understand why patients are afraid — the idea of surgery near the brainstem sounds terrifying," Dr. Cohen-Gadol said. - "But the reality, in experienced hands, is that this is a very safe, well-understood operation with a high rate of cure. What actually carries risk is not the surgery itself — it is inexperience. My job is to make sure patients have accurate information, not fear-based assumptions, when they are deciding between years of repeat injections and a single procedure that can end the problem."

Between the lines: - Hemifacial spasm is often misdiagnosed or overlooked for years before patients reach a specialist. - Dr. Cohen-Gadol has built a practice around cranial nerve disorders, which helps explain why patients seek him out for a second opinion. - He is one of a small number of neurosurgeons worldwide to receive the Vilhelm Magnus Medal from the Scandinavian Neurosurgical Society. - He founded the Neurosurgical Atlas, used by more than 70,000 physicians and surgeons worldwide. - That platform includes the chapter on microvascular decompression for hemifacial spasm, tying his clinical work to his teaching. - The message is clear: patients may want a surgical consultation before committing to years of repeat Botox.

What's next: - Patients can request remote review of imaging and symptom history before booking travel to Los Angeles. - Dr. Cohen-Gadol’s office offers consultation by phone at (310) 626-1312 and through the practice website. - For patients considering surgery, the next decision is whether they are a good candidate for microvascular decompression.