Abstract
Movement disorders of the face are frequent; they can be hypokinetic or hyperkinetic, primary or secondary, and be manifestations of an isolated condition or part of a generalized disorder. Hypokinetic movements such as hypomimia are characteristic of parkinsonian syndromes, while facial hyperkinetic movements are very common in certain forms of dystonia, dyskinesias, chorea, myoclonus, tremor, tics, and psychogenic movement disorders. Since these topics are covered extensively in other parts of the text, this chapter focuses on the clinical characteristics of movement disorders (centering on primary etiologies) when they affect the facial muscles and covers other entities that fall into the differential diagnosis. Emphasis is made on phenomenology with careful description of clinical signs and distinguishing features that may aid the diagnosis.
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Tardive oro-buccal lingual dyskinesias and craniocervical dystonia. Note the stereotypical lip puckering, grimacing, and tongue protrusion movements. She shows jaw-opening dystonia with mandibular deviation to the right and blepharospasm. You can hear the laryngeal stridor that interrupts her speech (MP4 12646 kb)
Facial tics. The young woman shows brief, rapid, repetitive left depressor anguli oris and platysma contractions, as well as increased blinking that increase when she talks. When asked to be quiet, the movements improve, almost disappearing. When she relaxes, the tics reappear. She explains that she can control the tics to a certain extent with a lot of concentration. She demonstrates the lower facial tics that also appear less often on the contralateral side (MP4 3734 kb)
Edentulous dyskinesias. Patient with loose dentures showing jaw deviation and jaw-closing stereotypic movement. He is explaining that he tends to remove the denture with his finger, as a habit. After removing the upper dentures, the movements almost completely disappear (MP4 46790 kb)
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Kurtis, M.M. (2017). Movement Disorders of the Face. In: Falup-Pecurariu, C., Ferreira, J., Martinez-Martin, P., Chaudhuri, K. (eds) Movement Disorders Curricula. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1628-9_39
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DOI: https://doi.org/10.1007/978-3-7091-1628-9_39
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