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Hemifacial spasm resulting from vertebral artery dolichoectasia
Dirk Deleu1, Boulenouar Mesraoua
1Department of Neurology (Medicine), Hamad Medical Corporation, Doha, State of Qatar. doc_deleu@hotmail.com
Saudi Medical Journal
|October 18, 2005
Summary
A case of hemifacial spasm revealed an uncommon cause: vertebral dolichoectasia. Magnetic Resonance Imaging (MRI) confirmed the diagnosis, and treatment with Botulinum toxin injections provided relief.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Hemifacial spasm is an involuntary contraction of facial muscles.
- Neurophysiological studies, such as the blink reflex, aid in diagnosis.
- Vascular compression of cranial nerves is a known etiology.
Observation:
- A 32-year-old male presented with left hemifacial spasm.
- Neurophysiological testing showed an absent ipsilateral R1 blink reflex.
- Magnetic Resonance Imaging (MRI) revealed a dolichoectatic left vertebral artery compressing the left facial nerve root.
Findings:
- Vertebral dolichoectasia, an uncommon cause, was identified as the etiology.
- Botulinum toxin injections effectively resolved the hemifacial spasm symptoms.
- MRI/MRA proved essential in diagnosing this specific case of hemifacial spasm.
Implications:
- Highlights the importance of advanced neuroimaging in evaluating hemifacial spasm.
- Demonstrates vertebral dolichoectasia as a treatable, albeit rare, cause of hemifacial spasm.
- Suggests considering vascular anomalies in the differential diagnosis of facial nerve disorders.