Micheli Federico; Scorticati, Maria Clara; Orueta, Ignacio Radi; Diaz, SergioClinical Neuropharmacology: May-June 1998 Article: PDF Only Buy Abstract Summary Hemifacial spasm features myoclonie-like, paroxysmal, unilateral muscle twitching, attributable to vascular compression at the facial pontine root entry zone. We present the case of an 85-year-old man who presented with idiopathic hemifacial spasm with onset 23 years before. For the last 5 years, he was successfully treated with botulinum toxin injections. However, occasional nitrate intake for precordial pain promptly triggered muscle twitching. Vasodilation may exacerbate not only cases of hemifacial spasm, but even of trigeminal neuralgia, both recognized as neurovascular compressive syndromes. © Williams & Wilkins 1998. All Rights Reserved.