We read with interest the review by Yaltho and Jankovic1 on the many faces of hemifacial spasm (HFS) and its different aetiologies. Among the multiple pathophysiological mechanisms, the investigators discussed the contribution of a hyperactive facial nucleus. We would like to add some clinical and electrophysiological evidence supporting this patho-genetic hypothesis.In the 1940s, Wartenberg2 described HFS in subjects who had previously received a limited facial wound by a bullet or as a consequence of the so-called "mensur," a ritual sword duel, and revised previous pertinent descriptions in the German literature.
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