Dr. HARITHA V

Dr.VIRNA SHAH

Abstract

MRI reports of 6 out of 8 patients with hemifacial spasm(HFS) within3 months showed neurovascular conflict(NVC) involving the 7th nerve with either anterior inferior cerebellar artery(AICA) or posterior inferior cerebellar artery (PICA). Severity of compression was moderate in 5 patients & mild-moderate in 1.These patients were treated with botulinum injections,(standard medical management for HFS) providing low-risk but limited symptomatic relief with high chances of recurrence; whereas surgical microvascular decompression treatment provides long lasting relief. 2 patients had rare etiologies (cavernoma and a large CP angle tumour) which required urgent neurosurgeon’s intervention, concluding the significance of MRI as the initial screening procedure in the assessment of patients with hemifacial spasm.

Literature shows NVC between 7th nerve & AICA is 43%, & PICA 31%. Severity of NVC is mild in 27%, moderate in 61%& severe in 12%. Incidence of tumor-induced HFS is 0.3% – 2.5%.

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