Diagnosis:
Clinical features:
- Episodic unilateral twitching of the face. May lead to eye closure, but is distinguished from blepharospasm by being unilateral and often having an upgoing forhead muscle ipsilateral to the facial twitch
- A type of segmental myoclonus involving the muscles supplied by the facial nerve (cranial nerve VII)
Investigations to consider:
Consider if atypical:
- MRI & MRA: cerebellopontine angle tumors (including epidermoid tumors, meningioma), basilar artery aneurysm.
Treatment:
- Botulinum toxin injection
- Consider: microvascular decompression (usually PICA, AICA or VA)
- Consider: carbamazepine, gabapentin or baclofen