Abstract

Hemifacial spasm (HFS) is a movement disorder disease consisting of involuntary and synchronous spasms in facial nerve innervated muscles, generally involving one half of the face. These spasms are known to be triggered by external factors. However, in classical presentations of HFS, the clinical findings are not affected by sensory tricks. In this article, we present a case of HFS who noted disappearance of symptoms by sensory trick. A previously healthy 57-year-old male patient was admitted with involuntary, synchronous and short-lasting contractions around the eye and the corner of the mouth on the left half of his face. The patient reported he incidentally realized that when he placed a piece of paper on the skin approximately over the junction of the zygomatic bone and orbicularis oculi on the side of the face where the spasms occur, the spasms totally disappeared or decreased. The patient was diagnosed with HFS based on the clinical and electrophysiological findings and treated with botulinum toxin type A. The spasms started to decrease four days after treatment and within two weeks the symptoms improved dramatically. Sensory-tricks, which are well-known clinical features of dystonia and are suggested to be associated with complex sensorimotor integration processes, were not reported in HFS. Our case suggested that suprasegmenter changes and consecutive development of sensory-trick might also occur in HFS.