Phenomenology in Craniofacial Movement Disorders: A Narrative Review

Craniofacial or cranial movement disorders are commonly seen in clinical practice. However, they are usually underdiagnosed or even misdiagnosed, leading to significant impairment in the quality of life of patients affected by these disorders. They are traditionally defined as movement disorders involving the face, jaw, tongue, and palate; but, it is possible to include the eye and ear based on the literature available. The current study aims to generally describe the phenomenology related to these abnormal movements for the general neurologist and practitioner. The most frequent are hemifacial spasm, blepharospasm, and myokymia. Other less commonly discussed are rabbit syndrome, apraxia of the eyelid opening/closing, tardive dyskinesia, chorea, tics, myorhythmia, dystonia, and tremor. Also, there are locations for the development of movement dis-orders, such as the ears (ear dyskinesia and ear myoclonus), chin (geniospasm), and tongue (lingual dystonia and lingual myoclonus) that are rarely discussed. Craniofacial movements are also seen in patients with autoimmune conditions, and the different features of these movements led to new terms like dystonic or dyskinetic stereotypies due to the dynamic change of the phenomenology. Another fact is that up to ten percent of patients with functional movement disorder will have craniofacial movement disorders.