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