How is facial myokymia differentiated from hemifacial spasm?

Updated: Sep 16, 2019
  • Author: Steven Gulevich, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Facial myokymia appears as vermicular twitching under the skin, often with a wavelike spread. This is distinguished from other abnormal facial movements by characteristic electromyogram discharges presenting as brief, repetitive bursts of motor unit potentials firing at 2-60 Hz interrupted by periods of silence of up to a few seconds. Facial myokymia may occur with any brainstem process. Severe cases may benefit from botulinum toxin. Most cases are idiopathic and resolve without treatment over several weeks.


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