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Facial myokymia in multiple system atrophy

S B Blunt1, N M Khalil, G D Perkin

  • 1Department of Neurology, Hammersmith Hospital, London, England, UK.

Movement Disorders : Official Journal of the Movement Disorder Society
|March 1, 1997
PubMed
Summary

Facial myokymia, involuntary facial muscle twitching, may be an underrecognized symptom of multiple system atrophy (MSA). This study highlights its clinical and electrophysiological features, suggesting brainstem origin in MSA patients.

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Area of Science:

  • Neurology
  • Neurophysiology

Background:

  • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
  • Facial myokymia is characterized by fine, undulating, wave-like movements of facial muscles.

Observation:

  • Two patients with multiple system atrophy (MSA) presented with clinically apparent facial myokymia.
  • The involuntary facial movements evolved in nature and severity during the illness course.
  • Electrophysiological studies confirmed myokymia and suggested brainstem origin.

Findings:

  • Facial myokymia in MSA exhibits electrical characteristics consistent with facial motorneuron hyperexcitability in the brainstem.
  • This contrasts with previously described facial action myoclonus in hereditary olivopontocerebellar atrophy (OPCA).

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Implications:

  • Facial myokymia may be more common in MSA than previously thought.
  • The evolving nature of these movements might lead to them being clinically missed.
  • Recognition of facial myokymia could aid in earlier MSA diagnosis and understanding of its pathophysiology.