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Hemifacial spasm: case report
J O Jowi1, J Matende, M I Macharia
1Kenyatta National Hospital, P.O. Box 19624-00202, Nairobi, Kenya.
East African Medical Journal
|November 9, 2006
Summary
A rare case of hemifacial spasm (HFS) was successfully treated with antibiotics and surgery. This highlights the importance of considering infections in HFS diagnosis.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Hemifacial spasm (HFS) is a neurological disorder characterized by involuntary contractions of facial muscles.
- While typically caused by vascular compression, other etiologies should be considered, especially in atypical presentations.
Observation:
- A 53-year-old female with diabetes mellitus presented with new-onset right-sided hemifacial spasm.
- Initial brain MRI revealed extensive pan-sinusitis and mastoiditis.
- Symptoms recurred after initial antibiotic treatment, necessitating further investigation.
Findings:
- Repeat imaging confirmed sinusitis, leading to Functional Endoscopic Sinus Surgery (FESS).
- Post-surgical management resulted in complete resolution of hemifacial spasm, with only mild intermittent blepharospasm remaining.
- Histopathological examination of surgical specimens is pending.
Implications:
- This case underscores a rare but treatable infectious/inflammatory cause of hemifacial spasm.
- Clinicians should maintain a high index of suspicion for sinusitis or mastoiditis in patients with recent-onset HFS.
- Prompt diagnosis and appropriate treatment, including antibiotics and potentially surgery, can lead to favorable outcomes.
