August 15, 2013 E-Pearl: Hemifacial spasm

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August 15, 2013

Hemifacial spasm is a repetitive, irregular, unilateral, involuntary tonic and/or clonic contraction of the muscles innervated by the ipsilateral facial nerve, with onset usually between 40 and 50 years of age. Imaging (MRI/MRA) may demonstrate vascular compression of the root exit zone of the ipsilateral facial nerve in most cases. [1]  Treatments include medication, botulinum toxin injection, and microvascular decompression. [2] 


1.  Tan NC, Chan LL, Tan EK. Hemifacial spasm and involuntary facial movements. QJM : monthly journal of the Association of Physicians 2002; 95: 493-500.

2. Costa J, Espirito-Santo C, Borges A et al. Botulinum toxin type A therapy for hemifacial spasm. Cochrane Database Syst Rev 2005: CD004899.

Submitted by Wenzhuan He, MD, MS; Resident Physician, Department of Neurology and Neurosciences, NJMS/UMDNJ, Newark, NJ

Dr.  He reports no disclosures. 

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