Secondary or symptomatic hemifacial spasm caused by a tumor of cerebellopontine angle Case report and review of the literature

Background & Importance: Primary hemifacial spasm is usually caused by microvascular compression of the facial nerve at its root exit zone at brainstem without any space-occupying pathology. Secondary or so-called symptomatic hemifacial spasm has an additional underlying pathology e.g. tumors leading to the microvascular compression. We review and discuss the pathophysiology and the literature of secondary hemifacial spasm. We report on a 23 year-old man with a secondary right-sided hemifacial spasm in association with an ipsilateral epidermoid tumor of the cerbello-pontine angle. Intraoperatively, no offending vessel was observed near the root exit zone of the facial nerve. Microsurgical tumor removal relieved the patient also from his hemifacial spasm.