Misdiagnosis Of Hemifacial Spasm Is A Frequent Event In The Primary Care Setting [erro Diagnóstico Do Espasmo Hemifacial é Ocorrência Frequente Em Unidades Primárias De Atenção à Saúde]

摘要

Primary hemifacial spasm (HFS) is characterized by irregular and involuntary contraction of the muscles innervated by the ipsilateral facial nerve. Treatment controls symptoms and improves quality of life (QoL). Objective: Evaluate the initial diagnosis and treatment of HFS prior to referral to a tertiary center. Method: We interviewed through a standard questionnaire 66 patients currently followed in our center. Results: Mean age: 64.19±11.6 years, mean age of symptoms onset: 51.9±12.5 years, male/female ratio of 1:3. None of the patients had a correct diagnosis in their primary care evaluation. Medication was prescribed to 56.8%. Mean time from symptom onset to botulinum toxin treatment: 4.34 ±7.1 years, with a 95% satisfaction. Thirty percent presented social embarrassment due to HFS. Conclusion: Despite its relatively straightforward diagnosis, all patients had an incorrect diagnosis and treatment on their first evaluation. HFS brings social impairment and the delay in adequate treatment negatively impacts QoL.