Article

Hemifacial spasm caused by epidermoid tumor at cerebello pontine angle.

Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Korea.
Journal of Korean Neurosurgical Society (impact factor: 0.6). 04/2009; 45(3):196-8. DOI:10.3340/jkns.2009.45.3.196
Source: PubMed

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.

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Keywords

36-year-old female patient
 
anterior inferior cerebellar artery
 
epidermoid tumor pathologically
 
epidermoid tumors
 
exit zone
 
facial nerve REZ
 
Hemifacial spasm
 
herb medication
 
imaging study
 
mass lesion
 
mass removal
 
Microvascular decompression
 
offending vessel
 
possible pathogenesis
 
progressive involuntary facial twitching
 
rare case
 
tumor compression
 
vascular compression
 
vascular compression theory
 
vascular malformations
 

Seok Keun Choi