Hemimasticatory spasm in hemifacial atrophy: Diagnostic and therapeutic aspects in two patients

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Abstract
We report two cases of hemimasticatory spasm in association with progressive hemifacial atrophy. On the basis of neurophysiological and magnetic resonance imaging assessments, a peripheral irritation of the trigeminal nerve–probably due to entrapment of the motor branches in the infratemporal fossa–is suggested as the cause of the involuntary movement. Local injections of botulinum toxin type A into the masticatory muscles proved to be a successful treatment in both patients.