Non-motor symptoms in primary hemifacial spasm: A case-control study

Abstract BACKGROUND: Primary hemifacial spasm (HFS) is caused by neurovascular conflict (NVC) at the root entry zone of the facial nerve. The literature on non-motor symptoms (NMS) in HFS is limited. OBJECTIVE: Study aimed to assess NMS in patients with primary HFS. METHODS: A cross-sectional, hospital-based, case-control study recruited 50 patients with primary HFS and 50 age- and sex-matched controls. Depression, anxiety, sleep quality, and fatigue were assessed using Beck’s depression inventory (BDI), Hamilton anxiety rating scale (HAM-A), Pittsburgh sleep quality index (PSQI), and fatigue assessment scale (FAS), respectively. RESULTS: A total of 30 female patients and 28 female controls were included in the study. The mean age of patients was 50.7 ± 10.7 years and that of controls was 52.4 ± 8.7 years. Seventeen patients (34%) and five controls (10%) had depression. The mean BDI score was significantly higher in patients (8.2 ± 5.6 vs. 4.0 ± 3.8; p = 0.01). Anxiety occurred in 40 patients (80%) and 4 controls (8%) (p = 0.01). The mean HAM-A score was significantly higher in patients (14.1 ± 7.0 vs. 4.8 ± 3.9; p = 0.02). The frequency of poor sleepers was significantly higher in patients (26% vs. 4%; p = 0.01); however, there was no significant difference in the mean PSQI scores (3.7 ± 4.2 vs. 1.3 ± 1.7; p = 0.08). The mean FAS score did not differ significantly between the groups (16.3 ± 3.3 vs. 14.1 ± 3.2; p = 0.24), and the fatigue frequency was similar in both groups. CONCLUSION: Primary HFS is associated with depression, anxiety, and poor sleep. This finding emphasizes the necessity for a psychiatric evaluation of depression and anxiety in patients with primary HFS.