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August 2006

Primary vs Postparalytic Hemifacial Spasm

Arch Neurol. 2006;63(8):1204. doi:10.1001/archneur.63.8.1204-a

We read with interest the recent article by Colosimo and colleagues1 on hemifacial spasm (HFS), a common movement disorder with a significant impact on quality of life.2 The excellent study, which provided a systematic clinical comparison between primary and secondary forms of HFS, highlighted useful clinical information. We were surprised by the high prevalence (23%) of postparalytic HFS among their study cohort. In our prospectively collected series of 200 consecutive HFS patients evaluated at a single tertiary center using similar inclusion criteria, postparalytic HFS accounted for less than 5% of the cases, similar to the 7% observed in another large series in an American cohort.3 This may represent differences in referring patterns among tertiary centers or differential susceptibility among races to HFS following facial nerve damage.