Hemifacial spasm caused by tortuous vertebrobasilar artery: a case report

Pramitha Nayana Librata, Achmad Firdaus Sani, Dedy Kurniawan, Muhammad Hamdan, Priya Nugraha

Research output: Contribution to journalArticlepeer-review


Background: Hemifacial spasm is a rare movement disorder. Prevalence estimates worldwide was 14.5 per 100,000 women and 7.4 per 100,000 men. Hemifacial spasm generally caused by compression of blood vessels at the root entry zone of the facial nerve in the brainstem, tortuous anteroinferior cerebellar artery (AICA) and posteroinferior cerebellar artery (PICA). Direct compression by vertebrobasilar dolichoectasia (VBD) with coincidence cavernoma is extremely rare. Case report: A 50-year-old woman with right hemifacial spasm for 1 year, with a history of hypertension for 10 years, did not take medication regularly. MRI MRA was performed showing suspicious dolichoectasia in the vertebrobasilar artery and cavernoma in the left basal ganglia. Then digital subtraction angiography was performed, it was found that the tortuous vertebrobasilar junction artery with a curve to the right caused right hemifacial spasm. Conclusion: Vascular imaging examination is important to do to find the cause of hemifacial spasm suspected to be due to vascular causes. The finding of two types of intracranial vascular malformations should be explored further. Therefore, the selection of therapy and management becomes more appropriate.

Original languageEnglish
Article number55
JournalEgyptian Journal of Neurology, Psychiatry and Neurosurgery
Issue number1
Publication statusPublished - Dec 2022


  • 8th nerve compression
  • Cavernoma
  • Hemifacial spasm
  • Vertebrobasilar dolichoectasia
  • Vertebrobasilar tortuous


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