title: Misdiagnosis of hemifacial spasm is a frequent event in the primary care setting.
abstract: Primary hemifacial spasm (HFS) is characterized by irregular and involuntary contraction of the muscles innervated by the ipsilateral facial nerve. Treatment controls symptoms and improves quality of life (QoL).
  
  
  
  Evaluate the initial diagnosis and treatment of HFS prior to referral to a tertiary center.
  
  
  
  We interviewed through a standard questionnaire 66 patients currently followed in our center.
  
  
  
  Mean age: 64.19±11.6 years, mean age of symptoms onset: 51.9±12.5 years, male/female ratio of 1:3. None of the patients had a correct diagnosis in their primary care evaluation. Medication was prescribed to 56.8%. Mean time from symptom onset to botulinum toxin treatment: 4.34 ±7.1 years, with a 95% satisfaction. Thirty percent presented social embarrassment due to HFS.
  
  
  
  Despite its relatively straightforward diagnosis, all patients had an incorrect diagnosis and treatment on their first evaluation. HFS brings social impairment and the delay in adequate treatment negatively impacts QoL.
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Sao PauloSP, Brazil, Departamento de Neurologia, Universidade Estadual de Campinas, Sao Paulo SP, Brazil;
authors.forename: Alberto R M
authors.initials: AR
authors.lastname: Martinez
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Sao PauloSP, Brazil, Departamento de Neurologia, Universidade Estadual de Campinas, Sao Paulo SP, Brazil;
authors.forename: Marcelo B
authors.initials: MB
authors.lastname: Nunes
authors.affiliation: Universidade Comunitária da Região de Chapecó, ChapecóSC, Brazil, Universidade Comunitária da Região de Chapecó, Chapecó SC, Brazil.
authors.forename: Nayara D
authors.initials: ND
authors.lastname: Immich
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Sao PauloSP, Brazil, Departamento de Neurologia, Universidade Estadual de Campinas, Sao Paulo SP, Brazil;
authors.forename: Luiza
authors.initials: L
authors.lastname: Piovesana
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Sao PauloSP, Brazil, Departamento de Neurologia, Universidade Estadual de Campinas, Sao Paulo SP, Brazil;
authors.forename: Marcondes
authors.initials: M
authors.lastname: França
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Sao PauloSP, Brazil, Departamento de Neurologia, Universidade Estadual de Campinas, Sao Paulo SP, Brazil;
authors.forename: Lidiane S
authors.initials: LS
authors.lastname: Campos
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Sao PauloSP, Brazil, Departamento de Neurologia, Universidade Estadual de Campinas, Sao Paulo SP, Brazil;
authors.forename: Anelyssa
authors.initials: A
authors.lastname: D'Abreu
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use; D003951:Diagnostic Errors; D005154:Facial Nerve; D005260:Female; D019569:Hemifacial Spasm / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use; D011320:Primary Health Care; D011788:Quality of Life; D012189:Retrospective Studies
chemical_list: D009465:Neuromuscular Agents; D001905:Botulinum Toxins