Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video

Facial myokymia is a rare clinical condition that manifests as subtle, involuntary and undulating “bag of worm-” like facial movements that is pathognomonic for brainstem pathology. Although most commonly the result of demyelinating disorders such as multiple sclerosis, it rarely portends a space-oc...

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Main Authors: Kautilya R. Patel, Abhijit Goyal-Honavar, Dhaval Shukla, Ravi Yadav
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Annals of Movement Disorders
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Online Access:https://doi.org/10.4103/aomd.aomd_70_24
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author Kautilya R. Patel
Abhijit Goyal-Honavar
Dhaval Shukla
Ravi Yadav
author_facet Kautilya R. Patel
Abhijit Goyal-Honavar
Dhaval Shukla
Ravi Yadav
author_sort Kautilya R. Patel
collection DOAJ
description Facial myokymia is a rare clinical condition that manifests as subtle, involuntary and undulating “bag of worm-” like facial movements that is pathognomonic for brainstem pathology. Although most commonly the result of demyelinating disorders such as multiple sclerosis, it rarely portends a space-occupying lesion in the brainstem, with isolated case reports of brainstem gliomas, metastatic tumors, cysticercal cysts, or tuberculomas. Here, we present the case of a 22-year-old patient with left facial myokymia and left hemifacial contracture, which were the sole presenting signs of a brainstem glioma. This report demonstrates the characteristics of these innocuous clinical signs on a clinical video and emphasizes the need to suspect an infiltrative brainstem lesion in a patient with facial myokymia, indicating prompt evaluation with brain magnetic resonance imaging.
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issn 2590-3446
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language English
publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
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series Annals of Movement Disorders
spelling doaj-art-bcfb34db6fd74a808f83d5e22be7ca612025-08-20T03:09:46ZengWolters Kluwer Medknow PublicationsAnnals of Movement Disorders2590-34462590-34542025-01-0181656710.4103/aomd.aomd_70_24Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical videoKautilya R. PatelAbhijit Goyal-HonavarDhaval ShuklaRavi YadavFacial myokymia is a rare clinical condition that manifests as subtle, involuntary and undulating “bag of worm-” like facial movements that is pathognomonic for brainstem pathology. Although most commonly the result of demyelinating disorders such as multiple sclerosis, it rarely portends a space-occupying lesion in the brainstem, with isolated case reports of brainstem gliomas, metastatic tumors, cysticercal cysts, or tuberculomas. Here, we present the case of a 22-year-old patient with left facial myokymia and left hemifacial contracture, which were the sole presenting signs of a brainstem glioma. This report demonstrates the characteristics of these innocuous clinical signs on a clinical video and emphasizes the need to suspect an infiltrative brainstem lesion in a patient with facial myokymia, indicating prompt evaluation with brain magnetic resonance imaging.https://doi.org/10.4103/aomd.aomd_70_24brainstem gliomafacial myokymiahemifacial contracturepontine glioma
spellingShingle Kautilya R. Patel
Abhijit Goyal-Honavar
Dhaval Shukla
Ravi Yadav
Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video
Annals of Movement Disorders
brainstem glioma
facial myokymia
hemifacial contracture
pontine glioma
title Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video
title_full Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video
title_fullStr Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video
title_full_unstemmed Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video
title_short Facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma: A clinical video
title_sort facial myokymia with hemifacial contracture as the sole manifestation of a pontine glioma a clinical video
topic brainstem glioma
facial myokymia
hemifacial contracture
pontine glioma
url https://doi.org/10.4103/aomd.aomd_70_24
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