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CASE PRESENTATION
2010-04-16R3 이진영
CASE10223881 M/48
C.C: Lt hemifacial spasm for 10 days
Hemifacial spasm due to Vascular Compression of fa-
cial N. Hemifacial spasm
• Sx complex of hyperactive dysfunction of unilateral facial nerve
• Spontaneous onset of intermittent twitching in orbicularis oculi muscle
spreads downward to include all facial muscle including platysma
• 40-50 years old age
Hemifacial spasm due to Vascular Compression of facial N.
Mechanism of hemifacial spasm• Vascular compression of facial nerve at root exit zone (central myelin changes
to peripheral myelin)
Role of neuroradiologic studies• Not only to exclude other causes but also
to detect vascular structures adjacent to N. root
Hemifacial spasm due to Vascular Compression of facial N
MR criteria• Compressive vessels : - Should run at right angles to nerve - Contact at root exit zone & deform root • Direction of compression: ventrocaudal
Assess the diagnostic accuracy of 3D MR images in preop. evaluation of hemifa-
cial spasm• 27 patients, surgically confirmed • Sensitivity 95%, specificity 77%Radiology 1995; 197:227-231
Left hernifacial spasm caused by compression by AICA
Left hemifacial spasm caused by compression by
PICA
REFERENCE
Hemifacial spasm and involuntary facial movements Radiology 1995; 197:227-231
Hemifacial Spasm : Three-dimen-sional
MR Images in Evaluation of Neurovascular Compression Radiology 1995; 197:227-231
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