Hemifacial spasm resulting from vertebral artery dolichoectasia.

A 32-year-old man presented with left hemifacial spasm. Neurophysiological findings revealed an absent ipsilateral R1 on blink reflex. An MRI showed a dolichoectatic left vertebral artery impinging on the root exit zone of the left facial nerve. Botulinum toxin infections relieved the manifestations of hemifacial spasm. This case demonstrates that MRI/MRA is an essential part of the work-up for hemifacial spasm, and shows that in accordance with the literature, vertebral dolichoectasia is an uncommon cause of hemifacial spasm.

[1]  E. Dietrichs,et al.  Prevalence of hemifacial spasm in Oslo, Norway , 2004, Neurology.

[2]  D. Deleu.  Levetiracetam in the treatment of idiopathic hemifacial spasm , 2004, Neurology.

[3]  T. Kawase,et al.  Angiographic manifestations and operative findings with 70 cases of hemifacial spasm: relation of common trunk anomalies. , 2003, The Keio journal of medicine.

[4]  Takuya Inoue,et al.  [A surgical case of hemifacial spasm caused by a tortuous, enlarged, and calcified vertebral artery]. , 2003, No shinkei geka. Neurological surgery.

[5]  L. Chan,et al.  Hemifacial spasm and involuntary facial movements. , 2002, QJM : monthly journal of the Association of Physicians.

[6]  S. Gebarski,et al.  Hemifacial spasm caused by vertebral artery dolichoectasia. , 2002, American journal of ophthalmology.

[7]  Jong-Hee Chang,et al.  Microvascular Decompression for Hemifacial Spasm: A Long-Term Follow-Up of 1,169 Consecutive Cases , 2002, Stereotactic and Functional Neurosurgery.

[8]  M. Ezura,et al.  Fusiform aneurysm of the vertebral artery presenting hemifacial spasm treated by intravascular embolization: case report. , 2001, Surgical neurology.

[9]  Joseph Jankovic,et al.  A case-controlled MRI/MRA study of neurovascular contact in hemifacial spasm. , 2000, Neurology.

[10]  A. Møller.  Vascular compression of cranial nerves: II: pathophysiology. , 1999, Neurological research.

[11]  J. Jankovic,et al.  Hemifacial spasm: Clinical findings and treatment , 1998, Muscle & nerve.

[12]  R. Wiet,et al.  Pitfalls in the Diagnosis of Hemifacial Spasm , 1997, The Laryngoscope.

[13]  C. Fischer,et al.  [Microsurgical vascular decompression in the treatment of facial hemispasm. A retrospective study of a series of 65 cases and review of the literature]. , 1996, Neuro-Chirurgie.

[14]  I. Casas Parera,et al.  [Dolichoectatic intracranial arteries. Advances in images and therapeutics]. , 1995, Medicina.