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Hemifacial Spasm From Lyme Disease: Antibiotic Treatment Points to the Cause

LeWitt, Tessa M.

doi: 10.1097/WNF.0000000000000193
Case Reports

A wide range of etiologies can cause hemifacial spasm (HFS), including infection. In this case report, a 44-year-old woman developed HFS and was explored surgically 7 years later. No abnormalities were found. Afterward, treatment of a surgical wound infection with an oral cephalosporin resulted in a temporary HFS remission that had never occurred previously. This antibiotic experience prompted further workup for an underlying infection, which ultimately led to diagnosis of Lyme disease. Presentation of HFS due to Lyme disease has not been reported. Because its diagnosis can be occult and antibiotic therapy can be both diagnostic and therapeutic, Lyme disease should be a consideration for cases of HFS.

College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI.

Address correspondence and reprint requests to Tessa M. LeWitt, PO Box 7853, Bloomfield Hills, MI 48302-7853; E-mail:

Conflicts of Interest and Source of Funding: The author has no conflicts of interest to declare.

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