Correlation of Severity of Hemifacial Spasm and MRI/MRA Brain Findings
Suntaree Thitiwichienlert¹, Varalee Mingkwansook², Paiboon Bawornwattanadilok¹, Rungrut Manakith¹, Grobgarn Wichitnark¹, Sopita Anantamongkonkul¹
Affiliation : ¹ Department of Ophthalmology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; ² Department of Radiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
Objective: To investigate the correlation between the clinical severity of hemifacial spasm (HFS) and brain magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) findings.
Materials and Methods: A prospective cohort study was conducted in 47 patients who underwent MRI/MRA brain at Thammasat Hospital and follow-up between January 1, 2023 and March 31, 2024. They were divided into two groups according to the clinical severity by Samsung Medical Center (SMC) grading as mild for SMC grade I and II, and severe for SMC grade III and IV. Neurovascular compression (NVC) severity in MRI/MRA brain findings was defined as mild for facial nerve abutment, moderate for nerve indentation, and severe for nerve course deviation.
Results: The mild spasm group included 22 cases and 11 cases or 50%, had mild compression, nine cases, or 40.9%, had moderate compression, and two cases, or 9.1%, had no compression. The severe spasm group included 25 cases and 15 cases, or 60%, had mild compression, eight cases, or 32%, had moderate compression, and two cases, or 8.0%, had no compression. The present study found no significant difference in clinical severity between moderate compression (p=0.491) and severe compression (p=0.526). Similarly, subgroup analysis revealed no significant difference in clinical severity between moderate (p=0.929) and severe compression (p=0.657) within each SMC grading feature subgroup. Most cases had benign causes, but two mild spasm cases presented with non-NVC, of which, one had meningioma, and another case an unruptured aneurysm.
Conclusion: Patients diagnosed with HFS should undergo brain MRI/MRA as cases may have non-NVC causes, which can have potential lifethreatening consequences.
Trial registration: The present study protocol was registered at the Thai Clinical Trials Registry (TCTR20240824001; date August 24, 2024).
Received 26 September 2024 | Revised 18 November 2024 | Accepted 25 November 2024
DOI: 10.35755/jmedassocthai.2025.1.72-79-01627
Keywords : Clinical severity; Hemifacial spasm; Brain magnetic resonance imaging; Magnetic resonance angiography
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