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Facial Myokymia and Hemifacial Spasm in Multiple Sclerosis: A Descriptive Study on Clinical Features and Treatment Outcomes

Marin Collazo, Iris, V., MD; Tobin, W., O., MB, BCh, BAO, PhD

doi: 10.1097/NRL.0000000000000163
Original Articles

Objective: Facial Myokymia and hemifacial spasm have been associated with multiple sclerosis; however, their etiology and clinical outcome is uncertain. Here, we describe the clinical, radiologic features, and treatment outcomes of a cohort of patients with multiple sclerosis and history of facial myokymia or hemifacial spasm.

Methodology: We reviewed the clinical features, radiologic features, and treatment outcomes of 35 patients with a diagnosis of multiple sclerosis and facial myokymia (28) or hemifacial spasm (7) seen at Mayo Clinic (Rochester, MN).

Results: Facial myokymia was associated with a clinical or radiologic relapse in 11 of 28 patients. In 27 of 28 patients with facial myokymia, symptom resolution occurred within months regardless of treatment. An ipsilateral pontine lesion was found in 3 of 7 cases with hemifacial spasm. Hemifacial spasm was associated with a clinical or radiologic relapse in 3 of 7 cases. Hemifacial spasm resolved within 4 years in 5 of 7 cases, with the remaining cases persisting up to 9 years despite treatment.

Conclusions: Facial myokymia and hemifacial spasm occurring in patients with multiple sclerosis is associated with an ipsilateral pontine MRI lesion in a minority of patients. Facial myokymia is a self-limited process while hemifacial spasm can be persistent in a minority of patients, despite treatment.

Department of Neurology, Mayo Clinic, Rochester, MN

This study has been approved by the Mayo Clinic institutional review board and has been performed in accordance with the ethical standards established in the 1964 Declaration of Helsinki.

The authors declare no conflict of interest.

Reprints: W. O. Tobin, MB, BCh, BAO, PhD, Consultant Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail:

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