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Hemifacial Spasm Caused by a Vein: A Case Report.
Jin Eun1, Jin-Gyu Choi1, Byung-Chul Son1,2
1Department of Neurosurgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
Asian Journal of Neurosurgery
|October 5, 2018
Summary
A rare case of hemifacial spasm (HFS) caused by a venous offender was successfully treated with microvascular decompression. This surgical approach offers excellent outcomes for HFS, emphasizing meticulous exploration for venous offenders.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Hemifacial spasm (HFS) is a neuromuscular disorder characterized by involuntary contractions of facial muscles.
- HFS caused by a venous offender compressing the facial nerve is uncommon, presenting diagnostic and therapeutic challenges.
Observation:
- A 57-year-old male presented with HFS affecting the frontalis, orbicularis oculi, orbicularis oris, and mentalis muscles, but not the platysma.
- Facial electromyography did not reveal a lateral spread response during the operation.
Findings:
- Successful treatment of HFS with microvascular decompression using Teflon felt.
- Excellent 12-month outcome with no complications following the surgical intervention.
Implications:
- Microvascular decompression is an effective surgical strategy for HFS caused by venous offenders.
- Thorough intraoperative visualization of the facial nerve root exit zone and identification of offending vessels are crucial for surgical success and preventing recurrence.
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