Vascular compression, hemifacial spasm, and multiple cranial neuropathy
Eidelman, B.H.; Nielsen, V.K.; Møller, M.; Jannetta, P.J.
Neurology 35(5): 712-716
1985
ISSN/ISBN: 0028-3878 PMID: 3990969 Document Number: 260942
Hemifacial spasm is usually an isolated symptom resulting from facial nerve root compression. Three patients had, in addition, tinnitus, hearing loss, facial sensory loss, diminished gag reflex, dysphagia and dysarthria. Acoustic reflexes were abnormal, and facial nerve conduction studies showed evidence of ephaptic transmission and ectopic excitation. Brain CT and metrizamide cisternography were normal. Surgical exploration showed compression of cranial nerve roots by posterior inferior cerebellar artery branches. After decompression, symptoms abated and electrical signs of hemifacial spasm disappeared. Vascular compression of nerve roots in the cerebellopontine recess may cause multiple cranial neuropathy.