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A case of bilateral alternating hemifacial spasms
J B van de Biezenbos1, M W Horstink, C J van de Vlasakker
1Institute of Neurology, University of Nijmegen, The Netherlands.
Summary
A young woman experienced alternating facial spasms on both sides of her face, two years after a facial palsy. This rare presentation of bilateral hemifacial spasm may indicate brainstem lesions from multiple sclerosis.
Area of Science:
- Neurology
- Neuroscience
- Ophthalmology
Background:
- Hemifacial spasm (HFS) is typically unilateral, characterized by involuntary contractions of facial muscles.
- Peripheral facial palsy can precede the development of secondary HFS.
- Bilateral HFS is rare, with alternating patterns being even less common.
Observation:
- A 24-year-old woman presented with alternating bilateral hemifacial spasms.
- The spasms began two years after experiencing a left peripheral facial palsy.
- The patient's HFS alternated sides, affecting the right and left face sequentially.
Findings:
- The unusual alternating bilateral HFS suggests a central nervous system etiology.
- Brainstem lesions, potentially from multiple sclerosis (MS), are implicated as the cause.
- The findings highlight the diverse neurological manifestations of MS.
Implications:
- This case expands the spectrum of clinical presentations for multiple sclerosis.
- It underscores the importance of considering central causes for atypical HFS.
- Further research into the neuroanatomical basis of alternating HFS is warranted.