ABSTRACT
CASE PRESENTATION A 55-year-old woman presented for a second opinion regarding a diagnosis of hemifacial spasm (HFS) because the spasms seemed to be spreading to the contralateral side. The patient’s symptoms had begun 3 years previously with intermittent twitching of the left eyelid. She was diagnosed with blepharospasm. Several months following this diagnosis she began to experience twitching of the left eyebrow, cheek, lip, and chin. She had never been exposed to dopamine receptor blocking drugs. Brain magnetic resonance imaging (MRI) with contrast revealed no abnormalities or enhancement within the facial nerve on the left side, but a prominent blood vessel was described around the root exit zone. In the absence of other symptoms in her neck, trunk, limbs, or contralateral face, she was diagnosed with left HFS.
