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Hemifacial Spasm
Philip R. Chapman, MD; H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Hemifacial spasm (HFS)
              • Synonyms

                • Primary HFS, facial nerve vascular loop syndrome, facial nerve hyperactive dysfunction syndrome
              • Definitions

                • Vascular compression of facial nerve at its root exit zone (REZ) within cerebellopontine angle (CPA) cistern causing ipsilateral hemifacial spasm

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Hughes MA et al: Imaging predictors of successful surgical treatment of hemifacial spasm. Brain Commun. 3(3):fcab146, 2021
                                        2. Yan X et al: Anatomical deviations of vertebral artery in hemifacial spasm: a quantitative study. Surg Radiol Anat. 43(2):291-9, 2021
                                        3. Chen SR: Neurological imaging for hemifacial spasm. Int Ophthalmol Clin. 58(1):97-109, 2018
                                        4. Ghali MGZ et al: Microvascular decompression for hemifacial spasm. Int Ophthalmol Clin. 58(1):111-21, 2018
                                        5. Hermier M: Imaging of hemifacial spasm. Neurochirurgie. 64(2):117-23, 2018
                                        6. Lefaucheur JP et al: Diagnosis of primary hemifacial spasm. Neurochirurgie. 64(2):82-86, 2018
                                        7. Haller S et al: Imaging of neurovascular compression syndromes: trigeminal neuralgia, hemifacial spasm, vestibular paroxysmia, and glossopharyngeal neuralgia. AJNR Am J Neuroradiol. 37(8):1384-92, 2016
                                        8. Chaudhry N et al: Hemifacial spasm: The past, present and future. J Neurol Sci. 356(1-2):27-31, 2015
                                        9. Lu AY et al: Hemifacial spasm and neurovascular compression. ScientificWorldJournal. 2014:349319, 2014
                                        10. El Refaee E et al: Value of 3-dimensional high-resolution magnetic resonance imaging in detecting the offending vessel in hemifacial spasm: comparison with intraoperative high definition endoscopic visualization. Neurosurgery. 73(1):58-67; discussion 67, 2013
                                        11. Li Y et al: Surgical treatment of hemifacial spasm with zone-4 offending vessel. Acta Neurochir (Wien). 155(5):849-53, 2013
                                        12. Mehanna R et al: Movement disorders in multiple sclerosis and other demyelinating diseases. J Neurol Sci. 328(1-2):1-8, 2013
                                        13. Chang CS et al: Gamma Knife surgery for hemifacial spasm related to cerebellopontine angle tumors. J Neurosurg. 117 Suppl:170-4, 2012
                                        14. Garcia M et al: High-resolution 3D-constructive interference in steady-state MR imaging and 3D time-of-flight MR angiography in neurovascular compression: a comparison between 3T and 1.5T. AJNR Am J Neuroradiol. 33(7):1251-6, 2012
                                        15. Rosenstengel C et al: Hemifacial spasm: conservative and surgical treatment options. Dtsch Arztebl Int. 109(41):667-73, 2012
                                        16. Dannenbaum M et al: Microvascular decompression for hemifacial spasm: long-term results from 114 operations performed without neurophysiological monitoring. J Neurosurg. 109(3):410-5, 2008
                                        17. Huh R et al: Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients. Surg Neurol. 69(2):153-7; discussion 157, 2008
                                        18. Kakizawa Y et al: Anatomical study of the trigeminal and facial cranial nerves with the aid of 3.0-tesla magnetic resonance imaging. J Neurosurg. 108(3):483-90, 2008
                                        19. Takao T et al: Three-dimensional visualization of neurovascular compression: presurgical use of virtual endoscopy created from magnetic resonance imaging. Neurosurgery. 63(1 Suppl 1):ONS139-45; discussion ONS145-6, 2008
                                        20. Tokucoglu F et al: Hemifacial spasm in correlation with electrophysiological and radiological findings. Acta Neurol Belg. 108(3):94-8, 2008
                                        21. Yuan Y et al: Microvascular decompression in patients with hemifacial spasm: report of 1200 cases. Chin Med J (Engl). 118(10):833-6, 2005
                                        22. Miwa H et al: Familial hemifacial spasm: report of cases and review of literature. J Neurol Sci. 193(2):97-102, 2002
                                        23. Jost WH et al: Botulinum toxin: evidence-based medicine criteria in blepharospasm and hemifacial spasm. J Neurol. 248 Suppl 1:21-4, 2001
                                        24. Lee MS et al: Clinical usefulness of magnetic resonance cisternography in patients having hemifacial spasm. Yonsei Med J. 42(4):390-4, 2001
                                        25. Yamakami I et al: Preoperative assessment of trigeminal neuralgia and hemifacial spasm using constructive interference in steady state-three-dimensional Fourier transformation magnetic resonance imaging. Neurol Med Chir (Tokyo). 40(11):545-55; discussion 555-6, 2000
                                        26. Møller AR: Vascular compression of cranial nerves: II: pathophysiology. Neurol Res. 21(5):439-43, 1999
                                        27. Mitsuoka H et al: Delineation of small nerves and blood vessels with three-dimensional fast spin-echo MR imaging: comparison of presurgical and surgical findings in patients with hemifacial spasm. AJNR Am J Neuroradiol. 19(10):1823-9, 1998
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Hemifacial spasm (HFS)
                                                    • Synonyms

                                                      • Primary HFS, facial nerve vascular loop syndrome, facial nerve hyperactive dysfunction syndrome
                                                    • Definitions

                                                      • Vascular compression of facial nerve at its root exit zone (REZ) within cerebellopontine angle (CPA) cistern causing ipsilateral hemifacial spasm

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Hughes MA et al: Imaging predictors of successful surgical treatment of hemifacial spasm. Brain Commun. 3(3):fcab146, 2021
                                                                              2. Yan X et al: Anatomical deviations of vertebral artery in hemifacial spasm: a quantitative study. Surg Radiol Anat. 43(2):291-9, 2021
                                                                              3. Chen SR: Neurological imaging for hemifacial spasm. Int Ophthalmol Clin. 58(1):97-109, 2018
                                                                              4. Ghali MGZ et al: Microvascular decompression for hemifacial spasm. Int Ophthalmol Clin. 58(1):111-21, 2018
                                                                              5. Hermier M: Imaging of hemifacial spasm. Neurochirurgie. 64(2):117-23, 2018
                                                                              6. Lefaucheur JP et al: Diagnosis of primary hemifacial spasm. Neurochirurgie. 64(2):82-86, 2018
                                                                              7. Haller S et al: Imaging of neurovascular compression syndromes: trigeminal neuralgia, hemifacial spasm, vestibular paroxysmia, and glossopharyngeal neuralgia. AJNR Am J Neuroradiol. 37(8):1384-92, 2016
                                                                              8. Chaudhry N et al: Hemifacial spasm: The past, present and future. J Neurol Sci. 356(1-2):27-31, 2015
                                                                              9. Lu AY et al: Hemifacial spasm and neurovascular compression. ScientificWorldJournal. 2014:349319, 2014
                                                                              10. El Refaee E et al: Value of 3-dimensional high-resolution magnetic resonance imaging in detecting the offending vessel in hemifacial spasm: comparison with intraoperative high definition endoscopic visualization. Neurosurgery. 73(1):58-67; discussion 67, 2013
                                                                              11. Li Y et al: Surgical treatment of hemifacial spasm with zone-4 offending vessel. Acta Neurochir (Wien). 155(5):849-53, 2013
                                                                              12. Mehanna R et al: Movement disorders in multiple sclerosis and other demyelinating diseases. J Neurol Sci. 328(1-2):1-8, 2013
                                                                              13. Chang CS et al: Gamma Knife surgery for hemifacial spasm related to cerebellopontine angle tumors. J Neurosurg. 117 Suppl:170-4, 2012
                                                                              14. Garcia M et al: High-resolution 3D-constructive interference in steady-state MR imaging and 3D time-of-flight MR angiography in neurovascular compression: a comparison between 3T and 1.5T. AJNR Am J Neuroradiol. 33(7):1251-6, 2012
                                                                              15. Rosenstengel C et al: Hemifacial spasm: conservative and surgical treatment options. Dtsch Arztebl Int. 109(41):667-73, 2012
                                                                              16. Dannenbaum M et al: Microvascular decompression for hemifacial spasm: long-term results from 114 operations performed without neurophysiological monitoring. J Neurosurg. 109(3):410-5, 2008
                                                                              17. Huh R et al: Microvascular decompression for hemifacial spasm: analyses of operative complications in 1582 consecutive patients. Surg Neurol. 69(2):153-7; discussion 157, 2008
                                                                              18. Kakizawa Y et al: Anatomical study of the trigeminal and facial cranial nerves with the aid of 3.0-tesla magnetic resonance imaging. J Neurosurg. 108(3):483-90, 2008
                                                                              19. Takao T et al: Three-dimensional visualization of neurovascular compression: presurgical use of virtual endoscopy created from magnetic resonance imaging. Neurosurgery. 63(1 Suppl 1):ONS139-45; discussion ONS145-6, 2008
                                                                              20. Tokucoglu F et al: Hemifacial spasm in correlation with electrophysiological and radiological findings. Acta Neurol Belg. 108(3):94-8, 2008
                                                                              21. Yuan Y et al: Microvascular decompression in patients with hemifacial spasm: report of 1200 cases. Chin Med J (Engl). 118(10):833-6, 2005
                                                                              22. Miwa H et al: Familial hemifacial spasm: report of cases and review of literature. J Neurol Sci. 193(2):97-102, 2002
                                                                              23. Jost WH et al: Botulinum toxin: evidence-based medicine criteria in blepharospasm and hemifacial spasm. J Neurol. 248 Suppl 1:21-4, 2001
                                                                              24. Lee MS et al: Clinical usefulness of magnetic resonance cisternography in patients having hemifacial spasm. Yonsei Med J. 42(4):390-4, 2001
                                                                              25. Yamakami I et al: Preoperative assessment of trigeminal neuralgia and hemifacial spasm using constructive interference in steady state-three-dimensional Fourier transformation magnetic resonance imaging. Neurol Med Chir (Tokyo). 40(11):545-55; discussion 555-6, 2000
                                                                              26. Møller AR: Vascular compression of cranial nerves: II: pathophysiology. Neurol Res. 21(5):439-43, 1999
                                                                              27. Mitsuoka H et al: Delineation of small nerves and blood vessels with three-dimensional fast spin-echo MR imaging: comparison of presurgical and surgical findings in patients with hemifacial spasm. AJNR Am J Neuroradiol. 19(10):1823-9, 1998