Nota Clínica

Hemifacial spasms and vertebral dolichoectasias

M. Arantes, R. Garcia, J.R. Pereira, M. Costa [REV NEUROL 2008;47:468-470] PMID: 18985596 DOI: https://doi.org/10.33588/rn.4709.2008077

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Volumen 47 | Number 09 | Nº of views of the article 7.033 | Nº of PDF downloads 496 | Article publication date 01/11/2008

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ABSTRACT

INTRODUCTION Hemifacial spasm (HFS) is characterized by chronic twitching or spasm of one side of the face. It affects muscles activated by the facial nerve. HFS is believed to result from irritation of the facial nerve at its exit from the brainstem and most cases are associated with a small vascular loop compression. Rarely it is associated with a vertebral artery dolichoectasia. CASE REPORTS. We report three cases of HFS whose magnetic resonance imaging and magnetic resonance angiography revealed vertebral dolichoectatic arteries compressing the facial nerve and causing HFS. These cases were selected from the group of patients of the dystonic outpatient clinics, Neurology Department, between April 1st 1998 and December 30th 2007.

CONCLUSIONS Magnetic resonance imaging and magnetic resonance angiography are essential for the diagnosis of a vertebral dolichoectasia and should be considered the initial screening procedures in the assessment of patients with HFS. The role of these neuroradiologic studies in the diagnosis of HFS is not only to detect the vascular structures running adjacent to the root exit zone that might distort the facial nerve and compress the brain stem around the root exit zone, but also to exclude other causes in a single non-invasive examination. KeywordsDolichoectasia Hemifacial spasm Magnetic resonance angiography Magnetic resonance imaging Vascular loop Vertebral artery CategoriesPatología vascular

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Hemifacial spasms and vertebral dolichoectasias