(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject
Facial Nerve
Description
This is a 45-year-old man with intermittent left facial twitching and eyelid closure for the last 6 months. With observation, spontaneous left facial spasms were seen involving the orbicularis oculi and oris muscles. With voluntary contraction of left facial muscles, with smiling for instance, there was more frequent and intense spasm. The diagnosis of left hemifacial spasm was made, and MRI demonstrated neurovascular contact involving the left facial nerve. Botulinum toxin injections resulted in significant symptomatic improvement.
