Sometimes nerves can be compressed and cause symptoms of dizziness, facial spasm or facial pain, depending on which nerve is affected. The compression is frequently caused by nearby blood vessels. These vessels are seen on the surface of the brain, near the affected nerve as it exits the brain and with each pulsation, the vessel “rubs” the nerve and over time alters the signal response of the nerve. Diagnosis requires a battery of tests, including imaging studies (MRI/MRA), balance testing (ENG/VNG), comprehensive hearing testing (audiometry) and ABR.
The most definitive treatment is surgery, in which the offending vessel is rotated away from the affected nerve. The surgery is called Microvascular Decompression. The Middle Fossa or Suboccipital Approach is used to access the nerve-vessel interface. A small piece of Teflon material is interposed between the vessel and nerve to prevent the vessel from coming into contact with the vessel again. Vascular compression syndromes associated with the ear and skull base are hemifacial spasm, trigeminal neuralgia and vertebral artery compression.