Hemifacial spasm caused by vertebral artery dolichoectasia.
OBJECTIVE
To display the characteristic magnetic resonance imaging (MRI) abnormalities associated with hemifacial spasm caused by compression of the seventh cranial nerve by a dolichoectatic vertebral artery.


METHODS
Interventional case report.


METHODS
Correlation of imaging and clinical findings.


RESULTS
In a 36-year-old man with mild left hemifacial spasm, MRI showed an enlarged (dolichoectatic) vertebral artery that compressed the seventh cranial nerve at its exit from the caudal pons. Manifestations of hemifacial spasm were relieved with periocular botulinum toxin injections.


CONCLUSIONS
In hemifacial spasm, MRI may show compression of the ipsilateral seventh cranial nerve or other structural abnormalities. Relief of hemifacial spasm may occur with botulinum toxin injection or with neurosurgical intervention designed to relieve the compression.
Rahman
Ersalan A
EA
Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan 48109, USA.
Trobe
Jonathan D
JD
Gebarski
Stephen S
SS
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D005155:Facial Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D019569:Hemifacial Spasm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology; D009465:Neuromuscular Agents / Q000627:therapeutic use; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000175:diagnosis
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A