Hemifacial spasm caused by pontine glioma: case report and review of the literature

Hemifacial spasm (HFS) is an involuntary paroxysmal contractions of the facial musculature, caused generally by vascular compression of the seventh cranial nerve at its root exit zone from the brain stem. The case of an adult man harbouring brain stem glioma (BSG) whose only neurological signs were left HFS and mild facial weakness is reported. Radiological and neurophysiological findings are described. No responsible vessel could be identified during surgery, but the causative lesion was found to be an astrocytic tumour encasing the facial nerve at its root exit zone from the brain stem. The rarity of such a condition prompted us to review the literature. Nine cases, including our patient presenting with HFS caused by BSG, are reviewed.