(The) association between vertebrobasilar dolichoectasia and hemifacial spasm

Abstract

Objective: Hemifacial spasm (HFS) is frequently caused by vascular compression of the facial nerve. Dolichoectasia of vertebrobasilar arteries (VBDE) may cause vascular crowding in the limited space of the posterior fossa, increasing the chance of vascular contact to the facial nerve. We investigated the prevalence of VBDE in HFS. Methods: We analyzed the presence of VBDE on MRI in patients with HFS and control subjects

age, sex and hypertension were matched. Two blinded readers independently assessed the images. We evaluated the vascular risk factors, including diabetes mellitus, hyperlipidemia, history of ischemic heart disease, and/or stroke, and the presence of lacunes on brain MRI. Results: A total of 620 subjects–310 HFS patients and 310 control subjects–were included. The prevalence of VBDE was higher in HFS patients (48/310, 15.5%) than in controls (10/310, 3.2%), with an odds ratio of 5.82 (95% confidence interval: 2.86–11.85, p < 0.001). The presence of facial nerve contacting vessels was more frequent in VBDE-positive HFS patients (81.3%) than VBDE-negative patients (54.2%), with an odds ratio of 3.48 (95% confidence interval: 1.60–7.57, p = 0.002). Among HFS patients, VBDE-positive patients showed to exhibit a higher mean age, as well as greater frequency of hypertension and history of ischemic heart disease than their VBDE-negative counterparts. Conclusions: We found that VBDE is associated with HFS in a portion of HFS patients. Since vascular risk factors were more frequently observed in VBDE-positive patients, an investigation of VBDE and its risk factors in patients with HFS may be served to prevent vascular complications.