Facial Spasm Caused by Compression of the Distal Portion of the Facial Nerve by the Anterior Inferior Cerebellar Artery, Resulting in Delayed Peripheral Facial Nerve Palsy: A Case Report.

Abstract

Delayed onset of facial spasm following surgery for unilateral facial spasm after microvascular decompression (MVD) of the distal facial nerve israre. We report a case of unilateral facial spasm caused bycompression of the distal facial nerve successfully treated with MVD resulting in delayedperipheral facial nerve palsy. A 51-year-old male patient with a left facial spasmshowed a gradual worsening of symptoms. Head imaging revealed that the left anterior inferior cerebellar artery (AICA) was in contact with the distal portion of the left facial nerve; hence, MVD was performed. The AICA waspressing on the distal facial nerve, so the AICA was transpositioned. Postoperatively, thefacial spasm improved. On the eighth postoperative day, the patient showed left peripheral facial nerve palsy and was given conservative treatment. The patient was discharged home on the sixteenth postoperative day. One month after discharge, thefacial palsy was in complete remission. Distal facial nerve compression may cause unilateral facial spasms.Although delayed facial nerve palsy may occur, the prognosis is good.