scholarly journals A rare case of unilateral hemifacial spasm and facial palsy associated with an abnormal anatomical variant of the posterior basilar circulation

2019 ◽  
Vol 101 (6) ◽  
pp. e1-e3
Author(s):  
J Chan ◽  
K Jolly ◽  
A Darr ◽  
DJ Bowyer
Keyword(s):  
Facial Nerve ◽  
Basilar Artery ◽  
Hemifacial Spasm ◽  
Neurological Deficit ◽  
Facial Palsy ◽  
Rare Case ◽  
Focal Neurological Deficit ◽  
Anatomical Variant ◽  
Vertebral Arteries ◽  
Facial Spasm

Tortuous vertebral arteries are a rare anatomical variant. Mild tortuosity is usually asymptomatic whereas severe tortuosity may present with ischaemic symptoms or compressive symptoms (focal neurological deficit). While a resulting hemifacial spasm has been previously described, sparse literature exists for its association with facial palsy. We present a rare case of facial spasm along with facial palsy in a 67-year-old woman who was found to have an anatomical variant in the posterior basilar circulation with an ectatic basilar artery and significantly displaced posterior vertebral artery impinging on the facial nerve.

Chiari Type I Malformation Presenting as Hemifacial Spasm: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 57 (2) ◽  
pp. E371-E371 ◽  
Author(s):  
Mustafa Efkan Colpan ◽  
Zeki Sekerci
Keyword(s):  
Facial Nerve ◽  
Posterior Fossa ◽  
Hemifacial Spasm ◽  
Chiari I Malformation ◽  
Posterior Fossa Decompression ◽  
Type I ◽  
Chiari Type I Malformation ◽  
Downward Displacement ◽  
Facial Spasm ◽  
Chiari I

ABSTRACT 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.

scholarly journals Hemifacial spasm secondary to middle ear cholesteatoma

2018 ◽  
Vol 97 (6) ◽  
pp. E31-E32
Author(s):  
Maheep Sohal ◽  
Nicholas Karter ◽  
Marc Eisen
Keyword(s):  
Facial Nerve ◽  
Middle Ear ◽  
Hemifacial Spasm ◽  
Final Diagnosis ◽  
Computed Tomographic Angiography ◽  
Vascular Compression ◽  
Computed Tomographic ◽  
Middle Ear Cholesteatoma ◽  
Facial Spasm ◽  
Tomographic Angiography

Hemifacial spasm is a peripheral myoclonus of the VIIth cranial nerve that is characterized by paroxysmal contraction of the muscles of facial expression. It exists in both primary and secondary forms. In rare cases, hemifacial spasm is caused by middle ear pathology. We describe the case of a 90-year-old man with recurrent cholesteatoma and tympanic segment fallopian canal dehiscence manifesting as right-sided hemifacial spasm. His history was significant for a right-sided tympanomastoidectomy for cholesteatoma 6 years earlier. Computed tomographic angiography performed to look for vascular compression of the facial nerve demonstrated a right middle ear opacification. Middle ear exploration revealed a completely dehiscent tympanic segment with cholesteatoma abutting the facial nerve. The overlying keratin debris and matrix were carefully dissected off, and facial nerve function was preserved. The final diagnosis was hemifacial spasm. During 14 months of postoperative follow-up, the patient experienced no further facial spasm.

Outcome following retrosigmoid microvascular decompression of the facial nerve for hemifacial spasm

2005 ◽  
Vol 119 (10) ◽  
pp. 779-783 ◽  
Author(s):  
D A Moffat ◽  
V S P Durvasula ◽  
A Stevens King ◽  
R De ◽  
D G Hardy
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Retrospective Review ◽  
Facial Palsy ◽  
Complete Resolution ◽  
Symptom Control ◽  
Short Term

This paper evaluates the outcome of retrosigmoid microvascular decompression of the facial nerve in a series of patients suffering from hemifacial spasm who had been referred to the skull-base team (comprising senior authors DAM and DGH). The paper is a retrospective review of 15 patients who underwent retrosigmoid microvascular decompression of the facial nerve at Addenbrooke's Hospital between 1985 and 1995. In this series it was possible to obtain complete resolution of hemifacial spasm in 93.3 per cent of cases in the short term and in 80 per cent in the long term. Twelve patients (80 per cent) were symptom-free post-operatively. Two patients had minor recurrence of symptoms occurring within six months of the procedure. One patient with no identifiable vascular impingement of the facial nerve had no improvement following surgery. Three patients suffered sensorineural hearing loss. Two patients complained of post-operative tinnitus, and transient facial palsy was noted in one patient.Retrosigmoid microvascular decompression of the facial nerve provides excellent long-term symptom control in a high percentage of patients with hemifacial spasm.

Hemifacial Spasm Caused by a Venule: Case Report

Neurosurgery ◽  
1984 ◽  
Vol 14 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Peter J. Jannetta
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Blood Vessels ◽  
Hemifacial Spasm ◽  
Vascular Compression ◽  
Entry Zone ◽  
Root Entry Zone ◽  
Facial Spasm ◽  
Posterior Direction ◽  
Anterior Posterior

Abstract The syndrome of hemifacial spasm occurs as a consequence of compression, almost universally by blood vessels, of the root entry zone of the facial nerve. The vascular compression is usually obvious at operation, but may be subtle. The author describes a case in which a venule running in an anterior-posterior direction across the caudal aspect of the root entry zone of the facial nerve, which was thought to be causing the spasm, was coagulated and divided. A small, more distal arteriole, probably not contributory, was decompressed away from the nerve. After operation, the patient improved gradually, and she remains free of facial spasm or weakness. This is the most subtle vascular compression seen by the author and his colleagues in over 400 microvascular decompressions for hemifacial spasm.

scholarly journals Spontaneous thrombosis of the main draining vein revealing an unruptured brain arteriovenous malformation

2015 ◽  
Vol 21 (2) ◽  
pp. 222-226 ◽  
Author(s):  
Catherine Cao ◽  
Nader Sourour ◽  
Vincent Reina ◽  
Aurélien Nouet ◽  
Federico Di Maria ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Neurological Deficit ◽  
Arteriovenous Malformations ◽  
Rare Case ◽  
Neurological Symptoms ◽  
Complete Regression ◽  
Review Of The Literature ◽  
Brain Arteriovenous Malformation ◽  
Spontaneous Thrombosis ◽  
Focal Neurological Deficit

Haemorrhage is the most frequent revealing condition of brain arteriovenous malformations (bAVMs). We report a rare case of unruptured parietal bAVM revealed by spontaneous thrombosis of the main draining vein, responsible for a focal neurological deficit. The bAVM was embolized in emergency conditions; complete regression of the neurological symptoms was observed within five days after the embolization. Potential mechanisms of such spontaneous thrombosis of the bAVM’s main drainage pathway as well as an exhaustive review of the literature concerning this rare revealing condition are presented and discussed.

scholarly journals Subarachnoid Hemorrhage Secondary to Forceful Sneeze

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Ali Zohair Nomani ◽  
Haris Majid Rajput ◽  
Mansoor Iqbal ◽  
Zakir Jan ◽  
Muhammad Irshad ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Neurological Deficit ◽  
Rare Case ◽  
Middle Aged ◽  
Focal Neurological Deficit ◽  
Cerebrovascular Accidents ◽  
Neurological Condition ◽  
The Past ◽  
Neurological Morbidity ◽  
Novel Associations

Subarachnoid hemorrhage (SAH) is a relatively less common but important neurological condition comprising 5% of all the cerebrovascular accidents. In most populations the reported incidence is 6-7 per 100,000 person-years and one-third of survivors become dependent. It is a serious but potentially treatable cause of neurological morbidity. Multiple authors have identified the most unusual novel associations and triggers of subarachnoid bleeds over the past decade. We herein report a rare case of subarachnoid hemorrhage leading to focal neurological deficit in a middle aged man secondary to forceful sneeze.

scholarly journals Clinical assessment of patients with primary and postparalytic hemifacial spasm: a retrospective study

2007 ◽  
Vol 65 (3b) ◽  
pp. 783-786 ◽  
Author(s):  
Andre Carvalho Felicio ◽  
Clecio de Oliveira Godeiro-Junior ◽  
Vanderci Borges ◽  
Sonia Maria de Azevedo Silva ◽  
Henrique Ballalai Ferraz
Keyword(s):  
Hemifacial Spasm ◽  
Symptom Onset ◽  
Facial Palsy ◽  
Disease Duration ◽  
Previous History ◽  
Vascular Abnormalities ◽  
Affected Side ◽  
The Face ◽  
Facial Spasm ◽  
History Of

OBJECTIVE: To compared the clinical features of 373 patients with primary and postparalytic hemifacial spasm (HFS). METHOD: Data analyzed were gender, ethnicity, age at symptom onset, disease duration, affected side, distribution of facial spasm at onset, hypertension, family history of HFS, previous history of facial palsy and latency between facial palsy and HFS. RESULTS:The prevalence of patients with Asian origin was similar in both groups such as female/male ratio, mean age at symptom onset, disease duration, affected side and distribution at onset of facial twitching. The upper left side of the face was the main affected region at onset. Almost 40% of the patients in both groups had hypertension. A prevalence of vascular abnormalities on the posterior fossa was seen in 7% and 12.5% of both groups. CONCLUSION: The clinical profile and radiological findings of patients with primary and postparalytic HFS are similar. The association of hypertension with vascular abnormalities and HFS was not frequent.

Hemifacial Spasm Due to Contralateral Aneurysmal Compression of the Facial Nerve Successfully Treated With Endovascular Coil Embolization: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 69 (3) ◽  
pp. E768-E772 ◽  
Author(s):  
Ichiro Nakagawa ◽  
Katsutoshi Takayama ◽  
Shinichiro Kurokawa ◽  
Takeshi Wada ◽  
Hiroyuki Nakagawa ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Coil Embolization ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Root Exit Zone ◽  
Parent Artery Occlusion ◽  
Facial Spasm ◽  
Endovascular Coil Embolization

Abstract BACKGROUND AND IMPORTANCE: Hemifacial spasm is usually caused by compression of the facial nerve at the root exit zone (REZ), whereas fusiform aneurysmal compression is extremely rare. The authors describe symptomatic hemifacial spasm caused by a contralateral fusiform aneurysm of the vertebral artery (VA) that was treated by endovascular coil embolization. CLINICAL PRESENTATION: A 55-year-old woman developed left hemifacial spasm that had gradually worsened over a period of 2 years before admission to our hospital. Cerebral angiography showed an elongated right VA fusiform aneurysm near the VA union that inclined toward the left side. The cause of the facial spasm was considered to be compression of the left facial nerve REZ by the aneurysm. Endovascular parent artery embolization including the aneurysm was performed. The hemifacial spasm disappeared within 3 months. CONCLUSION: Hemifacial spasm caused by contralateral VA fusiform aneurysm can be treated by intravascular parent artery occlusion with coil embolization.

scholarly journals A Rare Case of Cephalic Tetanus with Infranuclear Facial Palsy Following Foot Injury

2011 ◽  
Vol 2 (2) ◽  
pp. 131-133
Author(s):  
Srikanth Paleti ◽  
Srinivasa Rao B ◽  
Umakanth Venkat Kodali ◽  
Ranjith Kumar N ◽  
Suresh Babu P
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Cranial Nerve ◽  
Rare Case ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Medical Sciences ◽  
Cranial Nerve Palsies ◽  
Foot Injury ◽  
Cephalic Tetanus

We present here a rare case of cephalic tetanus with infranuclear facial nerve palsy following injury to the left foot with progression to generalized form, recovered completely in 6 weeks. There were few reports that cranial nerve palsies may occur in tetanus when the site of injury is other than in the head and neck, and indeed when there is no apparent site of entry of infection. In cephalic tetanus the prognosis is generally worse but here patient recovered completely without any residual paresis Key Words: Cephalic tetanus; Facial palsy; Foot injury DOI: http://dx.doi.org/10.3126/ajms.v2i2.4409 Asian Journal of Medical Sciences 2 (2011) 131-133

Sign in / Sign up

Export Citation Format

Share Document