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Young onset hemifacial spasm.

E K Tan1, L L Chan

  • 1Department of Neurology, Singapore General Hospital, Singapore. gnrtek@sgh.com.sg

Acta Neurologica Scandinavica
|June 16, 2006
PubMed
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Young-onset hemifacial spasm (HFS) accounts for 6.5% of cases and shares similar clinical features and neurovascular compression (NVC) with older patients. Unidentified factors may underlie NVC in younger individuals with HFS.

Area of Science:

  • Neurology
  • Neuroscience
  • Ophthalmology

Background:

  • Hemifacial spasm (HFS) commonly affects middle-aged individuals, with established etiology and clinical presentations.
  • Limited data exists on the pathogenesis of young-onset HFS, prompting investigation into age-related differences.
  • Potential age-related variations in HFS etiology and presentation warrant exploration.

Purpose of the Study:

  • To determine the prevalence and characteristics of young-onset HFS (age ≤30 years) in a tertiary referral center.
  • To compare the clinical and imaging features of young-onset HFS with those of elderly-onset HFS (age ≥65 years).

Main Methods:

  • A retrospective analysis of consecutive patients diagnosed with HFS.
  • Tabulation and comparison of demographic, clinical presentation, severity, and associated medical conditions.

Related Experiment Videos

  • Evaluation of neuroimaging findings, specifically neurovascular compression (NVC) of the facial nerve root exit zone (REZ).

    • Main Results:

    • Young-onset HFS represented 6.5% of the cohort (15 patients), while elderly-onset HFS comprised 21.7% (50 patients).
    • Young-onset HFS patients averaged 26.5 years at onset, with 80% being female. 75% exhibited NVC at the facial nerve REZ.
    • Upper eyelid twitching progressing to lower facial muscles was common (86.7%). Hypertension and diabetes were more prevalent in the elderly group, but NVC frequency was similar between age groups.

    Conclusions:

    • Young-onset HFS occurs in 6.5% of cases and presents similarly to elderly-onset HFS.
    • Clinical presentation and the frequency of neurovascular compression at the facial nerve REZ are comparable across age groups.
    • Genetic, anatomical, or other unidentified factors likely contribute to NVC in young-onset HFS.