Work

Hemifacial Spasms or Focal Aware Seizures: The Role of Video-EEG

Year: 2025

Type: article

Abstract: Hemifacial spasms (HFS) are common in neurological practice but can be mistaken for focal aware seizures without appropriate diagnostic workup. We present the case of a man in his 60s admitted for congestive heart failure (CHF) exacerbation, who developed left-sided weakness and HFS during hospitalization. Although his motor symptoms improved after receiving tenecteplase (TNK), the HFS persisted, prompting the use of continuous video-EEG to differentiate between cortical myoclonus and HFS. Video-EEG is essential for distinguishing HFS from focal aware seizures, identifying high-frequency ipsilateral muscle artifacts in HFS versus interictal or ictal EEG patterns contralateral to facial contractions in seizures. This case highlights key features to aid neurologists in differentiating these conditions.

Source: Cureus

DOI: 10.7759/cureus.80099

Authors: Juan A Moncayo, Walter R Duarte-Celada, Pamela Davila-Siliezar, Jannatul Ferdous

Institutions: Texas Tech University, Texas Tech University Health Sciences Center

Language: English

Topic: Epilepsy research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4408218182