Hemimasticatory spasm misdiagnosed as other mimickers: Report of two cases
- Author:
Hong-Hua Yuan
;
Woong-Woo Lee
;
Beom Seok Jeon
- Publication Type:Case Reports
- MeSH:
Nervous System Diseases
- From:Neurology Asia
2015;20(1):73-77
- CountryMalaysia
- Language:English
-
Abstract:
Hemimasticatory spasm is a rare neurologic disorder characterized by unilateral, paroxysmal involuntary
contraction of the masticatory muscles. It can be confused with other unilateral facial spasms. In this
report, we present two patients with hemimasticatory spasm who were initially misdiagnosed with
other disorders. The first patient was a 54-year-old man with a 9-year history of right facial spasm.
He underwent microvascular decompression, without benefit, at another hospital with the diagnosis
of hemifacial spasm two years prior to presenting at our hospital.On examination, right masseter and
temporalis muscles had irregular contractions with twitches and prolonged spasms. His brain magnetic
resonance imaging was normal.He showed a good response to carbamazepine. The second case was
a 60-year-old man presented with a 10-year history of jaw-closing movement. Previous treatment for
temporomandibular joint disorder was ineffective. He was previously diagnosed as oromandibular
dystonia at another hospital, and biperiden and diazepam treatment resulted in slight improvement.
There was tonic contraction and hypertrophy of the left masseter. He improved with carbamazepine.
These cases illustrate the importance of hemimasticatory spasm as differential diagnosis, and the good
response to carbamazepine.
- Full text:P020150623420030244041.pdf
