Background: Headache is one of the leading neurological disorders both globally and nationally, responsible for significant
morbidity and disability. Migraine headache disorder is a common headache disorder affecting at least 11% of
world’s population.
Case Report: We present a case of a patient who presented with migraine headaches associated with hemifacial spasm
(only during acute migraine attacks) along with upper cervical pain. She was offered right-sided C2-C3 and
C3-C4 intraarticular facet joint injections with steroid and local anesthetic under fluoroscopy. Significant relief
in headaches along with a complete resolution of hemifacial spasms was noted.
Conclusion: This outcome raises the possibility of underlying pathophysiological processes that could have been interrupted
by cervical facet joint steroid injection to stop the facial spasms. To the best of our knowledge, this is the first
case report of migraine headaches associated with hemifacial spasm that responded to cervical intraarticular
facet joint injection.
Key words: Facet joint injection, headache, hemifacial spasm, medial branch block, migraine, pathophysiology, spinal cord
stimulation, trigeminocervical complex
Spinal injection of local anesthetic during cervical facet joint injection