A Comparative Study of Primary and Secondary Hemifacial Spasm

Abstract

Background: Hemifacial spasm (HFS) is a common movement disorder.Objective: To evaluate possible differences in the demographic and clinical features between primary and secondary HFS.Design: In-person interview using a standardized questionnaire to collect demographic and clinical data.Setting: A multicenter study that included patients with HFS attending 3 Italian academic centers.Patients: Two hundred fourteen patients with HFS.Main Outcome Measure: A complete neurological examination assessed the current muscle distribution of spasm and the presence of synkinetic movements between upper and lower facial muscles. Results:The study sample comprised 214 patients with HFS, 81 men and 133 women, having a mean±SD age of 65.9±12.3 years; 164 patients were classified as having primary HFS and 50 patients (48 postparalytic and 2 symptomatic cases) were classified as having secondary HFS. Patients with primary and those with secondary HFS had similar mean±SD ages at onset (54.9±13.5 vs 57.0±12.8 years), male-female ratios (63:101 vs 18: 32), right-sided-left-sided HFS (77:86 [1 bilateral] vs 21:28 [1 bilateral]), and frequencies of familial cases (2.9% vs 2.0%), respectively. Most patients (65.0%) with primary HFS had initial symptoms of periocular muscle contractions alone and had subsequent involvement of the lower facial muscles. Most patients (72.0%) with secondary HFS reported initial involvement of the upper and lower facial muscles simultaneously. Signs of synkinesis were present in primary (43.3%) and secondary (58.0%) HFS.Conclusions: Patients with primary and those with secondary HFS share common demographic and clinical features, including sex distribution, age at onset, affected side of HFS, synkinesis, and rarity of familial cases. Signs of synkinesis were present in significant proportions of patients with primary or secondary HFS. The 2 forms differed in clinical presentation.

Multicentric comparative study of botulinum toxin treatment in patients with hemifacial spasm

“…From a demographic perspective, the study reveals a predominance of female patients, consistent with existing data suggesting a gender predisposition to HFS [ 4 – 6 ]. The mean age of onset aligns with previous studies, confirming that HFS primarily affects middle-aged and older individuals.…”

“…This difference may reflect factors such as access to healthcare, lifestyle, or genetic predispositions that vary between the two populations. All patients had unilateral HFS, with a slight predominance on the left side, a trend frequently reported in the literature [ 7 – 9 ].…”

Multicentric comparative study of botulinum toxin treatment in patients with hemifacial spasm

“…From a demographic perspective, the study reveals a predominance of female patients, consistent with existing data suggesting a gender predisposition to HFS [ 4 – 6 ]. The mean age of onset aligns with previous studies, confirming that HFS primarily affects middle-aged and older individuals.…”

“…This difference may reflect factors such as access to healthcare, lifestyle, or genetic predispositions that vary between the two populations. All patients had unilateral HFS, with a slight predominance on the left side, a trend frequently reported in the literature [ 7 – 9 ].…”

Outcome predictors, efficacy and safety of Botox and Dysport in the long‐term treatment of hemifacial spasm

“…The present study evaluated retrospectively 665 treatments with Botox and Dysport in a series of 108 HFS patients during a 10‐year period. Demographical data and clinical history of the patients are comparable with all previous observations: the percentage of patients with Bell’s palsy is comparable to the published rates ranging from 5% [2] to 22.4% [20]. Unintended hemifacial mass contractions can occur as a result of muscle synkinesis in patients with previous Bells’s palsy.…”

Outcomes of Microvascular Decompression for Hemifacial Spasm at the Philippine General Hospital

“…The demographic profile of the patients in this series is comparable to published literature—HFS is more common in females, 8 , 22 , 29 – 33 and has a 2:1 female-to-male ratio, 2 , 22 , 34 , 35 as seen in this series with a prevalence of females at 70.6% (female-to-male ratio of 2.4:1). It is more commonly unilateral, 29 , 30 , 33 , 36 , 37 and on the left side (61.8%). 29 , 33 …”

Multicentric comparative study of botulinum toxin treatment in patients with hemifacial spasm

“…From a demographic perspective, the study reveals a predominance of female patients, consistent with existing data suggesting a gender predisposition to HFS [ 4 – 6 ]. The mean age of onset aligns with previous studies, confirming that HFS primarily affects middle-aged and older individuals.…”

“…This difference may reflect factors such as access to healthcare, lifestyle, or genetic predispositions that vary between the two populations. All patients had unilateral HFS, with a slight predominance on the left side, a trend frequently reported in the literature [ 7 – 9 ].…”

Outcome predictors, efficacy and safety of Botox and Dysport in the long‐term treatment of hemifacial spasm

“…The present study evaluated retrospectively 665 treatments with Botox and Dysport in a series of 108 HFS patients during a 10‐year period. Demographical data and clinical history of the patients are comparable with all previous observations: the percentage of patients with Bell’s palsy is comparable to the published rates ranging from 5% [2] to 22.4% [20]. Unintended hemifacial mass contractions can occur as a result of muscle synkinesis in patients with previous Bells’s palsy.…”

Outcomes of Microvascular Decompression for Hemifacial Spasm at the Philippine General Hospital

“…The demographic profile of the patients in this series is comparable to published literature—HFS is more common in females, 8 , 22 , 29 – 33 and has a 2:1 female-to-male ratio, 2 , 22 , 34 , 35 as seen in this series with a prevalence of females at 70.6% (female-to-male ratio of 2.4:1). It is more commonly unilateral, 29 , 30 , 33 , 36 , 37 and on the left side (61.8%). 29 , 33 …”

Multicentric comparative study of botulinum toxin treatment in patients with hemifacial spasm

“…From a demographic perspective, the study reveals a predominance of female patients, consistent with existing data suggesting a gender predisposition to HFS [ 4 – 6 ]. The mean age of onset aligns with previous studies, confirming that HFS primarily affects middle-aged and older individuals.…”

“…This difference may reflect factors such as access to healthcare, lifestyle, or genetic predispositions that vary between the two populations. All patients had unilateral HFS, with a slight predominance on the left side, a trend frequently reported in the literature [ 7 – 9 ].…”

Outcome predictors, efficacy and safety of Botox and Dysport in the long‐term treatment of hemifacial spasm

“…The present study evaluated retrospectively 665 treatments with Botox and Dysport in a series of 108 HFS patients during a 10‐year period. Demographical data and clinical history of the patients are comparable with all previous observations: the percentage of patients with Bell’s palsy is comparable to the published rates ranging from 5% [2] to 22.4% [20]. Unintended hemifacial mass contractions can occur as a result of muscle synkinesis in patients with previous Bells’s palsy.…”

Outcomes of Microvascular Decompression for Hemifacial Spasm at the Philippine General Hospital

“…The demographic profile of the patients in this series is comparable to published literature—HFS is more common in females, 8 , 22 , 29 – 33 and has a 2:1 female-to-male ratio, 2 , 22 , 34 , 35 as seen in this series with a prevalence of females at 70.6% (female-to-male ratio of 2.4:1). It is more commonly unilateral, 29 , 30 , 33 , 36 , 37 and on the left side (61.8%). 29 , 33 …”