The treatment with alendronate in hemifacial spasm associated with Paget'sdisease of bone

The association of Paget's disease of bone and hemifacial spasm has rarely been reported. Hemifacial spasm is often associated with compression of the facial nerve by a vascular loop at the point where the nerve leaves the br ainstem before traversing the cerebellopontine angle. It is believed that n arrowing of the cerebellopontine angle cistern caused by Paget's disease in creases the chance of vascular compression of the facial nerve. Whilst spec ific antipagetic therapy such as calcitonin has been used with good respons e in hemifacial spasm associated with Paget's disease, the usefulness of th e newer bisphosphonates is not clear. A GS-year-old woman with hemifacial s pasm associated with Paget's disease was treated with alendronate, and the hemifacial spasm became very infrequent 4 months after commencement of the therapy. (C) 2000 Elsevier Science B.V. All rights reserved.