Hemifacial spasms, a manifestation of cerebrovascular complications, A: MRI solving the oral diagnostician's dilemma- A report of two cases

Hemifacial spasm (HFS) is a rare and debilitating neurological disorder characterized by involuntary unilateral contractions of facial muscles. Compression of the facial nerve root exit by a vascular loop, a condition termed as Dolichoectasia, is the main reason for its occurrence. Clinical diagnosis can be perplexing, but when combined with diagnostic imaging, can be extremely rewarding. Magnetic Resonance Imaging (MRI) of the brain can help to highlight Dolichoectasia in the neurovasculature along with damages to the brain tissue, thus simplifying such diagnostic dilemmas.We present two case reports of Hemifacial spasm secondary to cerebrovascular accident characterised by involuntary tics and facial spasms and medical history of cerebrovascular stroke. In both cases, MRI was instrumental by identifying underlying Dolichoectasia of the cerebral vasculature. This case report aims to highlight the importance of cerebrovascular complications as a potential cause of HFS and the role of MRI as a non-invasive diagnostic method in confirming the diagnosis of HFS.