Treatment of facial myokymia in multiple sclerosis with botulinum toxin

A 28-year-old male presented in our emergency neurological department with peripheral facial weakness and facial myokymia on the right side of his face. A month earlier he was seen by a neurologist because of hypoesthesia of the right side of his face. Neurological examination revealed mild ptosis o...

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Bibliographic Details
Published in:Acta neurologica Belgica 2012-12, Vol.112 (4), p.423-424
Main Authors: Habek, Mario, Adamec, Ivan, Gabelić, Tereza, Brinar, Vesna V.
Format: Article
Language:English
Subjects:
Adult
Biomedical and Life Sciences
Biomedicine
Botulinum Toxins, Type A - therapeutic use
Facial Nerve Diseases - complications
Facial Nerve Diseases - drug therapy
Facial Nerve Diseases - pathology
Humans
Magnetic Resonance Imaging
Male
Medicine/Public Health
Multiple Sclerosis - complications
Multiple Sclerosis - pathology
Neuro-Images
Neurology
Neuromuscular Agents - therapeutic use
Neuroradiology
Neurosciences
Pons - pathology
Treatment Outcome
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Summary:A 28-year-old male presented in our emergency neurological department with peripheral facial weakness and facial myokymia on the right side of his face. A month earlier he was seen by a neurologist because of hypoesthesia of the right side of his face. Neurological examination revealed mild ptosis of the right palpebrae and mild paralysis of the lower part of the right side of the face associated with persistent myokymia with myotonia of the right orbicularis oculi muscle (Video 1a), myokymia of the orbicularis oris muscle (Video 1b) and hypoesthesia of the right side of the face in the distribution of the second branch of the trigeminal nerve. Brain MRI revealed multiple supra and infratentorial demyelinating lesions (Fig. 1). He was treated with 1 g of intravenous methylprednisolone for 10 days without any recovery of facial myokymia. A period of 2 weeks passed without therapy to see if the disorder would recover spontaneously. After no improvement he was injected with 10 ...
ISSN:0300-9009
2240-2993
DOI:10.1007/s13760-012-0092-3