The facial tics.

The abnormal movements of the facial muscles are classified and the diagnosis and treatment considered in light of 22 cases of hemifacial spasm. Forms of treatment which give only temporary cessation of spasm and require complex and unpleasant treatment to be oft repeated are seldom tolerated for long by the patient. Permanent cure of spasm can only be obtained when the facial nerve or its branch to the muscle is permanently divided or the muscle itself excised. Neurotomy as practised by German (1942) and Scoville (1955) has not been found satisfactory in the present series. Neuro-anastomosis at different sites in the course of the 7th nerve is discussed and shown to be of value in patients with severe widespread spasm and in those in which the spasm is more localised. This method results in only temporary palsy of the facial muscles, the duration of the palsy depending on the site of the division of the facial nerve.