Facial Spasm Can Look Like Facial Weakness in Patients with Functional Disorders

Abstract

BL is a 42-year-old female businesswoman who presented to emergency services with a 6 h history of progressive unilateral sensory and motor disturbance in her face, arm, and leg. She had woken with some tingling on the right side of her face which she had put down to feeling tired. About 3 h later, her daughter aged 9 noticed that her face looked “funny.” When the patient looked in the mirror, she saw that her mouth was drooping on the right-hand side. She also became aware at the same time of some weakness and numbness in her right arm, especially in her hand. Her husband was familiar with the FAST test (Face, Arm, Speech Test) for the community recognition of stroke, and they immediately phoned emergency services who took her to accident and emergency. There was no associated headache. She had no past relevant medical history.