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Chiari type I malformation presenting as hemifacial spasm: case report
Mustafa Efkan Colpan1, Zeki Sekerci
1Department of Neurosurgery, Social Security Ankara Education and Research Hospital, Ankara, Turkey. colpan@iit.edu
Objective And Importance:
We report on a patient with a Chiari I malformation presenting with right hemifacial spasm. Clinicians should consider the downward displacement of the hindbrain as a rare cause of hemifacial spasm in Chiari I malformation.
Clinical Presentation:
An 18-year-old man was admitted with right hemifacial spasm. The results of the neurological examination were normal except for the facial spasm. Magnetic resonance imaging demonstrated a Chiari I malformation without syringomyelia. After surgery, the hemifacial spasm completely resolved.
Intervention:
Posterior fossa decompression, C1 laminectomy, and duraplasty were performed.
Conclusion:
The hemifacial spasm could be attributed to compression and/or traction of the facial nerve because of downward displacement of the hindbrain in Chiari I malformation. Compression and/or traction might create irritation of the facial nerve that causes hemifacial spasm. Resolution of the hemifacial spasm after posterior fossa decompression could explain the facial nerve irritation in Chiari I malformation. Clinicians should consider Chiari malformation as a cause of hemifacial spasm and posterior fossa decompression as a potential treatment.