title: Facial synkinesis as a first symptom of multiple sclerosis.
abstract: A 39-year-old woman was admitted to hospital because of a sensory hemisyndrome caused by a contrast-enhancing demyelinating lesion of the cervical cord. MRI, CSF examination and subsequent clinical and neuroradiological follow-up led to the diagnosis of multiple sclerosis. The patient had noticed an involuntary contraction of a small muscle fascicle on the right side of the chin for a year. Electromyographic and video recordings confirmed the synkinesis between the orbicularis oculi and lower facial muscles, a finding distinct from the myokymic discharges reported in multiple sclerosis and more similar to the synkinesis associated with hemifacial spasm.
authors.affiliation: Clinica Neurologica, Azienda Ospedaliero-Universitaria di Cagliari, Italy tacconi@medicina.unica.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tacconi
authors.affiliation: S.C. di Radiologia, Azienda Ospedaliera Brotzu, Cagliari, Italy.
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Peltz
authors.affiliation: Centro Sclerosi Multipla, Cagliari, Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Lorefice
authors.affiliation: Centro Sclerosi Multipla, Cagliari, Italy.
authors.forename: M Giovanna
authors.initials: MG
authors.lastname: Marrosu
authors.affiliation: Clinica Neurologica, Azienda Ospedaliero-Universitaria di Cagliari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Marrosu
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D004576:Electromyography; D005152:Facial Muscles / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis*; D013116:Spinal Cord / Q000000981:diagnostic imaging; D046608:Synkinesis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology
keywords: Multiple sclerosis; facial myokymia; facial synkinesis; hemifacial spasm