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Q J Med 2002; 95: 493-500
© 2002 Association of Physicians

Review

Hemifacial spasm and involuntary facial movements

N.-C. TAN, L.-L. CHAN1 and E.-K. TAN,2

From the SingHealth Polyclinics-Pasir Ris, and Departments of 1 Diagnostic Radiology and 2 Neurology, Singapore General Hospital, Singapore

Received 13 December 2001 and in revised form 7 March 2002

Hemifacial spasm (HFS) is characterized by tonic and clonic contractions of the muscles innervated by the ipsilateral facial nerve. It is important to distinguish this from other causes of facial spasms, such as psychogenic facial spasm, facial tic, facial myokymia, blepharospasm, and tardive dyskinesia. Magnetic resonance imaging and angiography studies frequently demonstrate vascular compression of the root exit zone of the facial nerve. Importantly, an underlying space-occupying lesion needs to be excluded in patients with associated atypical features such as facial numbness and weakness. Botulinum toxin injection to the facial muscles is an effective treatment for HFS, with few disabling side-effects.

Address correspondence to Dr E.-K. Tan, Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608. e-mail: gnrtek{at}sgh.com.sg


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