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We would like to thank Dr Tan and Dr Chan for their comments regarding our study on HFS. We agree that the main difference found between our patients and their series of HFS (ie, a higher prevalence of secondary cases) may be simply due to selection bias. Indeed, our academic clinics are referral centers for difficult cases of movement disorders for northern, central, and southern Italy, and therefore we more frequently see patients with secondary HFS, who may be more difficult to treat with botulinum toxin therapy.
Colosimo C, Bologna M, Lamberti S, Avanzino L, Marinelli L, Fabbrini G, Abbruzzese G, Defazio G, Berardelli A. Primary vs Postparalytic Hemifacial Spasm—Reply. Arch Neurol. 2006;63(8):1204. doi:10.1001/archneur.63.8.1204-b