Abstracts

Rationale: The differential diagnosis of involuntary facial movements can include focal motor seizures, hemifacial spasm, tics, and psychogenic attacks, and can at times be challenging. Methods: We reviewed all patients admitted to our epilepsy monitoring unit for diagnosis of facial movements. We analyzed all EEG-videos and examined which that were most helpful in obtaining a diagnosis. Results: 9 patients were identified. All had facial movements with intact awareness. Final diagnoses were as follows. 2 had focal seizures, one had EEG changes and one without. 2 had psychogenic events. 1 had Hemifacial Spasm. Diagnosis was made clinically. 1 had tics. Diagnosis was made clinically. 3 were clasified as others and could not be otherwise classified as seizures, tics, spasms or psychogenic seizures. Conclusions: The diagnosis of involuntary facial movements can be challenging, since EEG can be normal during “simple partial” seizures. The most helpful features were the analysis and correlation of continuous video EEG monitoring with clinical features. The lack of EEG changes was necessary but not sufficient to diagnose non-epileptic conditions.