This 66-year-old male has complained of a permanent right hemifacial spasm for 12 years. The botulinum toxin injections were only initially effective. Prior to the operation, the patient was suffering from a severe hemifacial spasm with tonic and clonic components. The CISS sequence of the MR imaging revealed a compression of the right facial nerve at its origin from the brainstem, caused by a loop of the anterior inferior cerebellar artery.

The hemifacial spasm has completely disappeared after the surgery. The patient does not have any neurological deficits.

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