J Korean Neurosurg Soc.  2009 Mar;45(3):196-198. 10.3340/jkns.2009.45.3.196.

Hemifacial Spasm Caused by Epidermoid Tumor at Cerebello Pontine Angle

• Choi SK
• Rhee BA
• Lim YJ

• KMID: 2189666
• DOI: http://doi.org/10.3340/jkns.2009.45.3.196

Abstract

Hemifacial spasm (HFS) is almost always induced by vascular compression but in some cases the cause of HFS are tumors at cerebellopontine angle (CPA) or vascular malformations. We present a rare case of hemifacial spasm caused by epidermoid tumors and the possible pathogenesis of HFS is discussed. A 36-year-old female patient presented with a 27-month history of progressive involuntary facial twitching and had been treated with acupuncture and herb medication. On imaging study, a mass lesion was seen at right CPA. Microvascular decompression combined with mass removal was undertaken through retrosigmoid approach. The lesion was avascular mass and diagnosed with an epidermoid tumor pathologically. Eventually, we found a offending vessel (AICA : anterior inferior cerebellar artery) compressing facial nerve root exit zone (REZ). In case of HFS caused by tumor compression on the facial nerve REZ, surgeons should try to find an offending vessel under the mass. This case supports the vascular compression theory as a pathogenesis of HFS.

Keyword

Hemifacial spasm; Facial nerve; Epidermal cyst

MeSH Terms

Acupuncture
Adult
Cerebellopontine Angle
Epidermal Cyst
Facial Nerve
Female
Glycosaminoglycans
Hemifacial Spasm
Humans
Microvascular Decompression Surgery
Vascular Malformations
Glycosaminoglycans