Hemifacial Spasm in a Child Treated With Microvascular Decompression of the Facial Nerve

Hemifacial spasm is a rare condition in children that is characterized by involuntary contractions of muscles innervated by the ipsilateral facial nerve.

We describe a 6-year-old girl who presented with intermittent involuntary spasms of the right face. Magnetic resonance imaging demostrated a loop of the anterior inferior cerebral artery contacting and elevating the cisternal segment of the right facial nerve; this finding was confirmed at surgery where microvascular decompression of the facial nerve was performed without complication. Following surgery she had immediate remission of symptoms, but the hemifacial spasms slowly recurred within 8 months of surgery only to resolve by age 11 years.

This is the youngest patient reported with hemifacial spasms related to a vascular etiology, which initially responded to surgical treatment. The authors review this syndrome in children and discuss possible etiologies and management options.