Hemifacial spasm resulting from vertebral artery dolichoectasia.
A 32-year-old man presented with left hemifacial spasm. Neurophysiological findings revealed an absent ipsilateral R1 on blink reflex. An MRI showed a dolichoectatic left vertebral artery impinging on the root exit zone of the left facial nerve. Botulinum toxin infections relieved the manifestations of hemifacial spasm. This case demonstrates that MRI/MRA is an essential part of the work-up for hemifacial spasm, and shows that in accordance with the literature, vertebral dolichoectasia is an uncommon cause of hemifacial spasm.
Deleu
Dirk
D
Department of Neurology (Medicine), Hamad Medical Corporation, Doha, State of Qatar. doc_deleu@hotmail.com
Mesraoua
Boulenouar
B
D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D018810:Magnetic Resonance Angiography; D008297:Male; D011859:Radiography; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*
D001905:Botulinum Toxins