Hemifacial Spasm Caused by a Remote Tentorial Meningioma: A Case Report and Review of the Literature

A 24-year-old female presented with right-sided hemifacial spasm (HFS). Imaging showed a right tentorial meningioma. The tumour was causing mass effect over the cerebellum. She underwent a right suboccipital craniotomy and excision of the lesion. Intraoperatively, it was found that the flocculonodular lobe was plugging the internal auditory meatus, thereby compressing the VII-VIII complex. Following surgery, she had complete relief of HFS. Remote tumours causing HFS are a rare phenomenon, with only a few cases reported in the literature. The causes of this phenomenon have been debated. In our patient, the tumour-related mechanical effect is the most probable mechanism for the HFS. The authors feel that an additional microvascular decompression may not be required in these cases. Remote tumours causing HFS are a rare phenomenon. To our knowledge, we report the fifth case in the literature of a remote tentorial meningioma causing HFS, with a review of the literature.