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Δευτέρα 16 Νοεμβρίου 2020

Recognising hemihypomimia as a mimic of 'facial weakness

alkiviadis.1961 shared this article with you from Inoreader

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Case descriptions

Patient A is a 69-year-old man with a 5-year history of progressive right hand then leg tremor, stiffness and slowness with recent diagnosis of Parkinson's disease (PD) 3 months prior to this encounter. Examination demonstrated unilateral right-sided facial droop at rest largely sparing the upper face and with accompanying decreased right lower facial muscle activation. Unified Parkinson's Disease Rating Scale motor examination score (UPDRS-III) was 26. UPDRS-III facial expression subscore had decre ased from 2 to 1 since starting carbidopa/levodopa 50–200 three times daily 3 months prior.

Similarly, patient B is a 77-year-old woman with a 3-year history of tremor starting in her left hand and a diagnosis of PD since 2017. Examination demonstrated resting unilateral left-sided facial droop involving both the upper and lower face with associated upper-worse-than-lower facial asymmetry. UPDRS-III score was 24 including a UPDRS facial expression score of 1. She has been treated with ropinirole...

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