A 56-YEAR-OLD, right-handed white woman presented in April 1999 for evaluation of hemifacial spasm. Her medical history was significant only for chronic sinusitis and dysmenorrhea. The patient had been in her usual state of health until late 1992, when she began to experience intermittent, painless spasms affecting the entire left side of the face (Figure 1). The spasms worsened during subsequent years and began to interfere with reading. She was eventually referred for neuro-ophthalmologic evaluation.
The patient's hemifacial spasms.
Magnetic resonance image showing a tortuous basilar artery (arrow) compressing the proximal portion of the left facial nerve (asterisk).
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