Abstract
Facial myokymia is a clinical sign that can occur as a manifestation of demyelinating lesions. As seen in our patient with multiple sclerosis, acute‐onset continuous facial myokymia can be indicative of an active lesion and can have localizing value.
Keywords: brainstem, facial myokymia, movement disorders, multiple sclerosis
Facial myokymia is a clinical sign that can occur as a manifestation of demyelinating lesions. As seen in our patient with multiple sclerosis, acute‐onset continuous facial myokymia can be indicative of an active lesion and of localizing value.
A 54‐year‐old woman with relapsing‐remitting multiple sclerosis (MS) presented with 3 days of continuous facial “quivering” after self‐discontinuing dimethyl fumarate. Examination revealed continuous right perioral myokymia (Video S1). Figure 1 shows her neuroimaging. She received intravenous methylprednisolone. At 1‐month follow‐up, facial myokymia (FM) had resolved and dimethyl fumarate was restarted.
Figure 1.
Axial (Panel A) and sagittal (Panel B) postgadolinium T1‐weighted brain MRI revealed a new enhancing lesion in the right superior pons (arrows), ipsilateral to the patient's perioral myokymia
Facial myokymia is an involuntary, abnormal activity consisting of undulating, vermicular movements. 1 , 2 FM has been associated with lesions of the postnuclear, postgenu portion of the ipsilateral facial nerve intra‐axially in the dorsolateral pontine tegmentum. 1 However, many cases show no intra‐axial demyelination of the facial nerve. 2 In MS patients, FM is usually self‐limited. 2
CONFLICT OF INTEREST
None declared.
AUTHOR CONTRIBUTIONS
JLC: contributed to the case concept and design, acquired the data, interpreted the data, and wrote the manuscript. MFV: contributed to the case concept and design, acquired the data, interpreted the data, and wrote the manuscript.
Supporting information
Video S1
ACKNOWLEDGMENT
Published with written consent of the patient.
Clay JL, Villamar MF. Continuous facial myokymia in multiple sclerosis. Clin Case Rep. 2020;8:2326–2327. 10.1002/ccr3.3135
REFERENCES
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Associated Data
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Supplementary Materials
Video S1