Many patients today read their MRI reports closely and often get confused when they see neurovascular conflict (NVC) on both sides of the face — even though they’re experiencing spasms only on one side.
Dr. Jaydev Panchawagh addresses this frequently asked concern in his talk. Here’s a detailed breakdown of what he says, straight from the transcript:
MRI findings can often be misleading. It is very imp to consider who reported the MRI.
Why Do Spasms Occur Only on One Side Even When MRI Shows Vessels on Both?
Two essential conditions must be met for a hemifacial spasm to occur:
So even if there’s a blood vessel on both sides, only the side where the nerve is sensitive will show spasms. On the other side, the nerve may have formed normally and isn’t vulnerable — hence, no spasm.
If there are no visible vessels on the MRI, Dr. Panchawagh advises:
In all patients with hemifacial spasm, the following conditions should be ruled out:
Sometimes patients forget they had Bell’s Palsy years ago — and only remember it when asked again.
The doctor shared that in the past 20 years, there has been only one case where no compressing vessel was found during surgery. That patient had multiple sclerosis, which she forgot to disclose earlier despite being asked.
MRI is only an indicator, not a final decision-maker.
Written by:
Dr. Jaydev Panchwagh
Neurosurgeon, M.Ch. in Neurosurgery
A distinguished Brain and Spine Surgeon, shaping neurosurgical care in Pune, Maharashtra, India for over two decades.
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