The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms
2011; Wiley; Volume: 26; Issue: 9 Linguagem: Inglês
10.1002/mds.23692
ISSN1531-8257
AutoresToby C. Yaltho, Joseph Jankovic,
Tópico(s)Botulinum Toxin and Related Neurological Disorders
ResumoMovement DisordersVolume 26, Issue 9 p. 1582-1592 Review The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms†‡ Toby C. Yaltho MD, Toby C. Yaltho MD Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USASearch for more papers by this authorJoseph Jankovic MD, Corresponding Author Joseph Jankovic MD [email protected] Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USAProfessor of Neurology, Director of Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, USASearch for more papers by this author Toby C. Yaltho MD, Toby C. Yaltho MD Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USASearch for more papers by this authorJoseph Jankovic MD, Corresponding Author Joseph Jankovic MD [email protected] Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USAProfessor of Neurology, Director of Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, USASearch for more papers by this author First published: 05 April 2011 https://doi.org/10.1002/mds.23692Citations: 139 † Relevant conflicts of interest/financial disclosures: Nothing to report. ‡ Full financial disclosures and author roles may be found in the online version of this article. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Hemifacial spasm is defined as unilateral, involuntary, irregular clonic or tonic movement of muscles innervated by the seventh cranial nerve. Most frequently attributed to vascular loop compression at the root exit zone of the facial nerve, there are many other etiologies of unilateral facial movements that must be considered in the differential diagnosis of hemifacial spasm. The primary purpose of this review is to draw attention to the marked heterogeneity of unilateral facial spasms and to focus on clinical characteristics of mimickers of hemifacial spasm and on atypical presentations of nonvascular cases. In addition to a comprehensive review of the literature on hemifacial spasm, medical records and videos of consecutive patients referred to the Movement Disorders Clinic at Baylor College of Medicine for hemifacial spasm between 2000 and 2010 were reviewed, and videos of illustrative cases were edited. Among 215 patients referred for evaluation of hemifacial spasm, 133 (62%) were classified as primary or idiopathic hemifacial spasm (presumably caused by vascular compression of the ipsilateral facial nerve), and 4 (2%) had hereditary hemifacial spasm. Secondary causes were found in 40 patients (19%) and included Bell's palsy (n = 23, 11%), facial nerve injury (n = 13, 6%), demyelination (n = 2), and brain vascular insults (n = 2). There were an additional 38 patients (18%) with hemifacial spasm mimickers classified as psychogenic, tics, dystonia, myoclonus, and hemimasticatory spasm. We concluded that although most cases of hemifacial spasm are idiopathic and probably caused by vascular compression of the facial nerve, other etiologies should be considered in the differential diagnosis, particularly if there are atypical features. © 2011 Movement Disorder Society Supporting Information Additional Supporting Information may be found in the online version of this article. Filename Description MDS_23692_sm_suppvideo.mpg16.7 MB Supporting Video Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. References 1 Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. 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