Teaching Video NeuroImages: Hemifacial spasm due to cerebellopontine angle mass

A 21-year-old woman presented with tremor of the right eyelid that progressed in 1 year to involve the ipsilateral cheek and lip and ipsilateral hearing loss since childhood. Her lack of medical comorbidities prompted imaging that revealed a mass in the right cerebellopontine angle cistern. She underwent debulking of the mass, which resolved the tremors. Her pathology revealed pilocytic astrocytoma (figure; video at Neurology.org). Cranial nerve 7 is predisposed to injury due to its anatomic location. There are many case reports of hemifacial spasms due to mass effect.1 Imaging should be performed in otherwise healthy patients to exclude secondary causes of spasms.2
Source: Neurology - Category: Neurology Authors: Tags: Tremor, Primary brain tumor, Adolescence RESIDENT AND FELLOW SECTION Source Type: research