HYBRID EVENT: You can participate in person at Orlando, USA or Virtually from your home or work.

6th Edition of International Conference on Neurology and Brain Disorders

October 24 -26, 2022

October 24 -26, 2022 | Orlando, Florida, USA
INBC 2022

Mary Kemberly S Trinidad

Speaker at Neurology and Brain Disorders 2022 - Mary Kemberly S Trinidad
Perpetual Succour Hospital, Philippines
Title : Hemifacial Spasm In A 66-Year-Old Filipino Male Caused By Vertebrobasilar Artery Dolichoectasia: A Case Report


Background:  Hemifacial spasm (HFS), characterized by unilateral, intermittent contractions of the muscles of facial expression occurs due to vascular compression of the facial nerve at the root exit zone. Few studies demonstrated the total prevalence of HFS in range of 9.8 to 11 per 100,000 in the total population with very limited knowledge on its prevalence in Asia, most specifically in the Philippines. Direct compression of the facial nerve by Vertebrobasilar dolichoectasia (VBD) is an even rarer cause of HFS, representing 0.7% of cases.

Objective: This paper presents a rare case of hemifacial spasm caused by vertebrobasilar artery dolichoectasia with multiple cranial nerve compression in a 66-year-old Filipino male presenting with involuntary twitching of the left side of the face, its clinical manifestation, diagnosis and management.

Case: A case of a 66-year-old Filipino male who presented with a six-year history of progressive involuntary twitching of the left side of the face, started on Botulinum Toxin periorbital injection treatment. Initial MRI was unremarkable. During subsequent clinic visits, more prominent and sustained contractions of the left side of the face were noted despite more frequent injections with lesser interval. Repeat MRI revealed a tortuous and ectatic vertebrobasilar artery, compressing and dorsally displacing the left Cranial Nerves V, VII and VIII. Referral to a neurosurgeon for microvascular decompression was done.

Conclusion: Vertebrobasilar dolichoectasia can rarely compress the facial nerve leading to hemifacial spasm. Although the diagnosis is led by clinical features, Magnetic Resonance Imaging (MRI) is a useful imaging technique for demonstrating the nerve compression. Widely accepted treatment modalities include Botulinum Toxin (BTX) Injections as less invasive procedure, providing symptomatic relief and Microvascular Decompression (MVD) as the more definite treatment.

KeyWords: hemifacial spasm, vertebrobasilar artery dolichoectasia, botulinum toxin, microvascular decompression, twitching

In this presentation, a rare case will be presented and discussed. The audience will be reviewed on hemifacial spasm, its causes, risks, manifestations, diagnostic and therapeutic management. In the research field, this case report will be a documentation of vertebrobasilar artery dolichoectasia as a rare cause of hemifacial spam.


Dr. Mary Kemberly S. Trinidad is a graduate of Doctor of Medicine in Cebu Institute of Medicine last 2018 and passed the Philippines Physicians Licensure Exam on 2019. She started her Internal Medicine residency training on the same year at Perpetual Succour Hospital – Department of Internal Medicine and is currently a 3rd year medical resident in training.