Disparity in Periocular Manifestations between Hemifacial Spasm and Post-Paralytic facial Syndrome

Abstract Objective This study aims to describe the differences in periocular manifestations among patients with hemifacial spasm and post-paralytic facial syndrome. Methods A retrospective study was conducted at two tertiary-care eye centers in Riyadh, Saudi Arabia. Data of patients with hemifacial spasm and post seventh nerve paralytic facial syndrome who received management and follow-up at the two hospitals were collected from the electronic medical records. Results We had a total of 67 subjects with abnormal facial movement, out of which 33 patients had hemifacial spasm and 34 patients had post-paralytic facial syndrome. 39 (58.2%) were female and 28 (41.8%) were male. The average age of the subjects under study was 46.5 years. Clinical features were noted for patients with hemifacial spasm including orofacial muscle twitching in 31 patients (93.9%), eyelid ptosis in five patients (15%), reveres ptosis in one patients (3%), no brow ptosis, and complaints of one eye being smaller than the other eye in five patients (15%). Among patients with post-paralytic facial syndrome, orofacial muscle twitching was found in 23 patients (67.6%), eyelid ptosis in 32 patients (94%), reveres ptosis in 29 patients (85.3%), brow ptosis in 28 patients (82.4%), and complaints of one eye being smaller than the other eye in 94.1%. Conclusion We have observed that patients with post-paralytic facial syndrome tend to exhibit periocular manifestations such as eyelid ptosis, reverse ptosis and brow ptosis more frequently than patients with hemifacial spasm.