Christopher Adams, Ali Samii, Turner Peckham, Manuel Ferreira
{"title":"Microvascular Decompression in a Patient With Positional Hemifacial Spasm: Case Report.","authors":"Christopher Adams, Ali Samii, Turner Peckham, Manuel Ferreira","doi":"10.1227/neuprac.0000000000000163","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and importance: </strong>Hemifacial spasm (HFS) is known to be caused by certain activities and, in rare cases, has been shown to be position-dependent. This is the first case of HFS caused in a patient when lying in a prone position that completely resolved after surgical decompression.</p><p><strong>Clinical presentation: </strong>A 29-year-old female presented with HFS when lying in the prone position. In this case, the trigeminal, facial, and vestibulocochlear nerves were abutted by the anterior inferior cerebellar artery, posterior inferior cerebellar artery, and 2 small vessels. Microvascular decompression resulted in relief from the HFS.</p><p><strong>Conclusion: </strong>In cases where vessels abut but do not compress the facial nerve, there can still be position-dependent HFS because of position-dependent compression of the facial nerve, which can be relieved by surgical decompression.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000163"},"PeriodicalIF":0.6000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560691/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosurgery practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1227/neuprac.0000000000000163","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background and importance: Hemifacial spasm (HFS) is known to be caused by certain activities and, in rare cases, has been shown to be position-dependent. This is the first case of HFS caused in a patient when lying in a prone position that completely resolved after surgical decompression.
Clinical presentation: A 29-year-old female presented with HFS when lying in the prone position. In this case, the trigeminal, facial, and vestibulocochlear nerves were abutted by the anterior inferior cerebellar artery, posterior inferior cerebellar artery, and 2 small vessels. Microvascular decompression resulted in relief from the HFS.
Conclusion: In cases where vessels abut but do not compress the facial nerve, there can still be position-dependent HFS because of position-dependent compression of the facial nerve, which can be relieved by surgical decompression.
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