Oral Radiology

, Volume 34, Issue 3, pp 273–276 | Cite as

Hemifacial spasm secondary to vascular loop compression: a rare case report

  • Pratibha S. SharmaEmail author
  • Atul P. Sattur
  • Preetam B. Patil
  • Kirty R. Nandimath
  • Kruthika S. Guttal
  • Krishna Burde
Case Report


Hemifacial spasm (HFS) is characterised by brief, persistent, involuntary paroxysmal contractions of the facial muscles innervated by the facial nerve. Broadly its aetiology is portrayed as primary and secondary. Primary HFS is a result of vascular compression of the ipsilateral facial nerve at its root exit zone, and secondary HFS can occur after any injury to the facial nerve from the internal auditory canal to the stylomastoid foramen, which may be a result of a cerebellopontine angle tumour, schwannoma, fusiform aneurysm, or demyelinating lesion such as multiple sclerosis. We report a rare case of HFS in a 40-year-old female patient, who presented with a 4-year history of twitching of the left eye and deviation of the mouth towards the left side. An MRI of the brain revealed a vascular anomaly at the root exit zone of the left facial nerve. The present report aims to highlight MRI as a single, non-invasive diagnostic investigation to confirm the diagnosis of HFS.


Involuntary facial twitching Tortuous vertebral artery Vascular compression Magnetic resonance imaging Hemifacial spasm 


Compliance with ethical standards

Conflict of interest

Pratibha S. Sharma, Atul P. Sattur, Preetam B. Patil, Kirty R. Nandimath, Kruthika S. Guttal and Krishna Burde declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5). Informed consent was obtained from all patients for being included in the study.

Research involving human participants and/or animals

This article does not contain any studies with animal subjects performed by any of the authors.


  1. 1.
    Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. Muscle Nerve. 1998;21:1–8.Google Scholar
  2. 2.
    Tan EK, Jankovic J. Psychogenic facial spasm and hemifacial spasm. J Neuropsychiatry Clin Neurosci. 2001;13:380–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Ehni G, Woltman HW. Hemifacial spasm. Arch Neurol Psychiatry. 1945;53:205–11.CrossRefGoogle Scholar
  4. 4.
    Abbruzzese G, Berardelli A, Defazio G. Hemifacial spasm. Handb Clin Neurol. 2011;100:675–80.CrossRefPubMedGoogle Scholar
  5. 5.
    Tan EK, Jankovic J. Bilateral hemifacial spasm: report of five cases and a literature review. Mov Disord. 1999;14:345–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Colosimo C, Bologna M, Lamberti S, Avanzino L, Marinelli L, Fabrinni G, et al. A comparative study of primary and secondary hemifacial spasm. Arch Neurol. 2006;63(3):441–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Montaner J, Alvarez-Sabin J, Rovira A, Molina C, Grive E, Codina A, et al. Vertebrobasilar abnormalities in patients with hemifacial spasm: MR-angiograph findings. Rev Neurol. 1999;29(8):700–3.PubMedGoogle Scholar
  8. 8.
    Niwa Y, Shiotam M, Karasawa H, Ohseto K, Naganuma Y. Trigeminal neuralgia caused by tortuous vertebrobasilar system—the clinical and imaging features. Rinsho Shinkeigaku. 1997;37(3):191–7.PubMedGoogle Scholar
  9. 9.
    Titlic M, Vrebalov-Cindro V, Lahman-Doric M, Buca A, Jukic I, Tonkic A. Hemifacial spasm in vertebrobasilar dolichoectasia. Acta Neurol Belg. 2006;106:23–5.PubMedGoogle Scholar
  10. 10.
    Jowi JO, Matende J, Macharia MI. Hemifacial spasm: case report. East Afr Med J. 2006;83:401–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Poungvarin N, Devahastin V, Viriyavejakul A. Treatment of various movement disorders with botulinum A toxin injection: an experience of 900 patients. J Med Assoc Thai. 1995;78:281–8.PubMedGoogle Scholar
  12. 12.
    Rosenstengel C, Matthes M, Baldauf J, Fleck S, Schroeder H. Hemifacial spasm—conservative and surgical treatment options. Dtsch Arztebl Int. 2012;109(41):667–73.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Auger RG, Whisnant JP. Hemifacial spasm in Rochester and Olmstead County, Minnesota, 1960 to 1984. Arch Neurol. 1990;47:1233–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Lu AY, Yeung JT, Gerrard JL, Michaelides EM, Sekula RF, Bulsara KR. Hemifacial spasm and neurovascular compression. Sci World J. 2014;2014:349319.Google Scholar
  15. 15.
    Tash R, DeMerritt J, Sze G, Leslie D. Hemifacial spasm: MR imaging features. AJNR. 1991;12:839–42.PubMedGoogle Scholar
  16. 16.
    Tan NC, Chan LL, Tan EK. Hemifacial spasm and involuntary facial movements. QJM. 2002;95:493–500.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society for Oral and Maxillofacial Radiology and Springer Japan KK 2017

Authors and Affiliations

  1. 1.Department of Oral Medicine and RadiologySDM College of Dental Sciences and HospitalDharwadIndia
  2. 2.Department of RadiodiagnosisSDM College of Medical Sciences and HospitalDharwadIndia

Personalised recommendations