Continuous facial myokymia (CFM) is an involuntary undulating, vermicular movement that spreads across facial muscles and is associated with a characteristic electromyographic pattern. It is an infrequent clinical sign that almost always occurs in intrinsic brainstem lesions, particularly in multiple sclerosis (MS). It is usually present for only a few weeks, but it may persist for long periods of time being very troublesome for patients. We report 2 cases with MS and continuous hemifacial myokymia persisting for up to 1 month which disappeared after injection of botulinum toxin. Botulinum toxin A (BTX-A) has been used successfully to treat a variety of focal dystonias and occasionally in orbicularis myokymia, but its use has not been reported in continuous hemifacial myokymia. BTX-A appears to be effective and safe for treating persistent facial myokymia in MS patients.

Keywords:
Botulinum toxin, Facial myokymia, Multiple sclerosis
1.
Gutmann L: Facial and limb myokymia. Muscle Nerve 1991;14:1043–1049.
2.
Auger RG: AAEM minimonograph 44: Diseases associated with excess motor unit activity. Muscle Nerve 1994;17:1250–1263.
3.
Gutmann L, Thompson HG, Martin JD: Transient facial myokymia: An uncommon manifestation of MS. JAMA 1969;209:389–391.
4.
Blunt SB, Khalil NM, Perkin GD: Facial myokymia in multiple system atrophy. Mov Disord 1997;12:235–238.
5.
Jacobs L, Kaba S, Pullicino P: The lesion causing continuous facial myokymia in multiple sclerosis. Arch Neurol 1994;51:1115–1119.
6.
Jordan DR: Intractable orbicularis myokymia. Opthalmic Surg 1989;20:280–283.
7.
Ruusuvaara P, Setäla K: Long-term treatment of involuntary facial spasms using botulinum toxin. Acta Opthalmol 1990;68:331–338.
8.
Smith KJ, McDonald WI: Spontaneous and evoked electrical discharges from a central demyelinating lesion. J Neurol Sci 1982;55:39–47.
9.
Jankovic J, Brin MF: Therapeutic uses of botulinum toxin. N Engl J Med 1991;324:1186–1194.
10.
Davis D, Jabbari B: Significant improvement of stiff-person syndrome after paraspinal injection of botulinum toxin A. Mov Disord 1993;8:371–373.
© 2000 S. Karger AG, Basel
2000
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.