Spontaneous Resolution of Hemifacial Spasm Following Falcotentorial Meningioma Resection: Impact of Posterior Cranial Fossa Volume Changes on Hemifacial Spasm

A 56-year-old, previously healthy woman underwent imaging evaluation for nuchal pain, which revealed a falcotentorial meningioma measuring approximately 3.6 cm in maximum diameter. The tumor caused mild compression of the cerebellum and brainstem, and the nuchal pain was attributed to foramen magnum syndrome associated with the lesion. However, the patient had also experienced right hemifacial spasm (HFS) for several years. Initially, tumor resection alone was performed, and remarkably, the right HFS was found to have spontaneously resolved seven years later. Given that the spontaneous remission of HFS is exceedingly rare, we report this case along with a literature review addressing the clinical course and potential underlying mechanisms responsible for the natural resolution of HFS.