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The lesion causing continuous facial myokymia in multiple sclerosis
L Jacobs1, S Kaba, P Pullicino
1Department of Neurology, Buffalo General Hospital.
Archives of Neurology
|November 1, 1994
Summary
Continuous facial myokymia (CFM) in multiple sclerosis (MS) is caused by pontine tegmental lesions affecting the facial nerve. Magnetic resonance imaging (MRI) can identify these lesions in most affected patients.
Area of Science:
- Neurology
- Neuroimaging
- Demyelinating Diseases
Background:
- Continuous facial myokymia (CFM) is a rare neurological symptom.
- The precise anatomical location of lesions causing CFM in multiple sclerosis (MS) requires further elucidation.
Purpose of the Study:
- To identify the specific lesion site responsible for continuous facial myokymia (CFM) in multiple sclerosis (MS) using magnetic resonance imaging (MRI).
Main Methods:
- A case series design was employed, examining 12 patients with MS and CFM using brain MRI.
- MRI scans were also performed on 57 MS patients without CFM and on eight CFM patients before, during, and after symptom resolution.
Main Results:
- In 11 of 12 patients, CFM was linked to intraaxial lesions in the dorsolateral pontine tegmentum involving the facial nerve.
- Lesions often resolved on MRI after CFM cessation.
- A pontine tegmental lesion was present in 17% of MS patients without CFM.
Conclusions:
- Continuous facial myokymia in MS is definitively caused by pontine tegmental lesions affecting the facial nerve.
- MRI successfully identifies these lesions in approximately 90% of MS patients with CFM.
- Similar lesions may be found in a subset of MS patients lacking CFM.