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This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. His vital signs were within normal limits. The patient was referred to Neurology. The most common physical signs and symptoms of MS include constitutional symptoms, muscle weakness, motor and autonomic spinal cord symptoms, paresthesias, and vision changes. Facial myokymia has also been described in the recovery phase of Guillain-Barre syndrome.

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It can sometimes be seen during a relapse [ 2 ]. He was not treated with botulinum toxin. Facial myokymia has also been described in the recovery phase of Guillain-Barre syndrome. MRI is utilized today as a marker in treatment response. Most common causes are thought to be related to autoimmune, genetic, viral, and environmental factors.

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It was felt by Neurology that the location of the lesions would be consistent with his symptoms. There was a dominant focus of hyperintense signal lateral to the right atrium extending to the right posterior medial temporal lobe measuring up to 18 millimeters. Spasms were noted of his left eyelid with several brief episodes of left hemifacial spasm. A year-old male presents with several weeks of what he described as spasms of his left eyelid which progressed to episodes of twitching of his left eye and left cheek. The difference in the EMG findings appears to be whether individual muscles or groups of muscles are involved myokymia and whether the firing is nonsustained HFS or sustained SPHC [ 2 — 4 ]. Conclusions Here we present an unusual presentation of multiple sclerosis diagnosed in a year-old male with facial myokymia of left eyelid, which progressed to left hemifacial spasm.

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Description: Multiple sclerosis MS is a chronic inflammatory demyelinating disease of the central nervous system. He denied history of tobacco, drug, or alcohol abuse. Case Reports in Neurological Medicine. Myokymia, with or without progression to facial intermittent spasm, and with or without sustained contractures, is said in the literature to be an uncommon presentation of multiple sclerosis. There was a dominant focus of hyperintense signal lateral to the right atrium extending to the right posterior medial temporal lobe measuring up to 18 millimeters. He did not take any prescribed, herbal, or over the counter medications.
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