Although the neurologic manifestations of multiple sclerosis are variable, a recognized, although infrequent, finding is continuous unilateral facial myokymia and contraction.1-4 The occurrence of this unusual entity, particularly when unaccompanied by more common manifestations of multiple sclerosis, may be confusing, and its occurrence in this illness should be considered when examining patients with abnormal facial movements. The present report describes a patient with unilateral facial contraction and myokymia without other signs of multiple sclerosis and discusses these findings in relationship to other causes of myokymia and abnormal facial movements.
A 24-year-old woman came for neurologic consultation because of a one-month history of continuous twitching and contraction of the right side of her face. The twitching was first noted below the eye, developed over a period of four days, and remained stable since then. She had no diplopia, visual loss, dysphagia, abnormality of taste or hearing, numbness, incoordination,