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Facial spasm is a rare disease characterized by asymmetric contractions and involuntary paroxysmal activity of facial muscles. It is often unilateral disease and leads to an uncomfortable and injurious situation that affects patients’ quality of life. Most often, it begins gradually in the orbicularis oculi muscle, followed by involvement of the ipsilateral inferior face . The spasms are usually caused by PICA and AICA vascular compression (vertebral artery compression is more rare) of the facial nerve root, in its entry zone. Botulinum toxin injection in the involved facial muscle is a treatment option, however has transient benefits during the therapy. Microvascular decompression is an effective treatment, with low complication rates. We report a case of a 65-year-old patient with sporadic involuntary contractions of left orbicular muscle , with an insidious and progressive character. Microsurgical decompression with Teflon interposition between the left vertebral artery and the facial nerve in the posterior fossa was performed. There was a significant clinical improvement, with progressive decrease of the spasms until complete remission.

Resultados tardios da descompressão microvascular do nervo facial pela artéria vertebral