Psychogenic Facial Spasm
A 35-year-old woman evaluated for left hemifacial spasm. Neurologic examination demonstrated reduction of left side facial spasm during distracting maneuvers. Contraction of the frontalis muscle involved the eyebrow contralateral to the spasm of the orbicularis oculi. Electrophysiologic evaluation disclosed a normal blink reflex without evidence of ephaptic transmission and disappearance of EMG contraction during sleep, by polysomnography. Psychiatric evaluation led to the diagnosis of conversion disorder.
Francesca Morgante, MD, PhD
CONTINUUM: Lifelong Learning in Neurology. 19(5, Movement Disorders):1383-1396, October 2013