title: Accommodative esotropia: an unrecognized cause of hemifacial spasm in children.
abstract: Pediatric hemifacial spasm can be a sign of an intracranial tumor. We examined two females, ages 2 and 6 years, who presented with hemifacial spasm as an early sign of accommodative esotropia. Initial ophthalmologic examination disclosed high hyperopia without detectable esotropia. Both children developed an intermittent esotropia over the following month. In the first child, the hemifacial spasm resolved concurrent with the onset of amblyopia. In the second child, spectacle correction produced immediate cessation of the spasms. In both children, squinting to avoid diplopia produced an overflow facial movement that manifested as hemifacial spasm. Accommodative esotropia should be considered in the differential diagnosis of pediatric hemifacial spasm.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock 72202, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Brodsky
authors.forename: A H
authors.initials: AH
authors.lastname: Thomas
mesh_terms: D000550:Amblyopia; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004172:Diplopia; D004948:Esotropia / Q000150:complications* / Q000175:diagnosis; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology*; D006801:Humans; D016896:Treatment Outcome