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Psychogenic Facial Spasm

Legend: 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.

Duration: 0:28

Associated with: CONTINUUM: Lifelong Learning in Neurology. 19(5):1383-1396, October 2013

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