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Olfactory and Gustatory Function in Early-Stage Parkinson’s Disease: Implications for Cognitive Association
Jeongjae Lee, Young Eun Kim, Joong Seob Lee, Suk Yun Kang, Min Seung Kim, In Hee Kwak, Jaeseol Park, Jung Yeon Nam, Hyeo-il Ma
J Mov Disord. 2024;17(4):450-452.   Published online June 27, 2024
DOI: https://doi.org/10.14802/jmd.23243
  • 894 View
  • 56 Download
PDFSupplementary Material
Brief communication
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Evaluating the Validity and Reliability of the Korean Version of the Scales for Outcomes in Parkinson’s Disease–Cognition
Jinse Park, Eungseok Oh, Seong-Beom Koh, In-Uk Song, Tae-Beom Ahn, Sang Jin Kim, Sang-Myung Cheon, Yoon-Joong Kim, Jin Whan Cho, Hyeo-Il Ma, Mee Young Park, Jong Sam Baik, Phil Hyu Lee, Sun Ju Chung, Jong-Min Kim, Han-Joon Kim, Young-Hee Sung, Do Young Kwon, Jae-Hyeok Lee, Jee-Young Lee, Ji Seon Kim, Ji Young Yun, Hee Jin Kim, Jin Yong Hong, Mi-Jung Kim, Jinyoung Youn, Hui-Jun Yang, Won Tae Yoon, Sooyeoun You, Kyum-Yil Kwon, Su-Yun Lee, Younsoo Kim, Hee-Tae Kim, Joong-Seok Kim, Ji-Young Kim
J Mov Disord. 2024;17(3):328-332.   Published online April 3, 2024
DOI: https://doi.org/10.14802/jmd.24061
  • 1,622 View
  • 87 Download
AbstractAbstract PDFSupplementary Material
Objective
The Scales for Outcomes in Parkinson’s Disease–Cognition (SCOPA-Cog) was developed to assess cognition in patients with Parkinson’s disease (PD). In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPACog (K-SCOPA-Cog).
Methods
We enrolled 129 PD patients with movement disorders from 31 clinics in South Korea. The original version of the SCOPA-Cog was translated into Korean using the translation-retranslation method. The test–retest method with an intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient were used to assess reliability. Spearman’s rank correlation analysis with the Montreal Cognitive Assessment-Korean version (MOCA-K) and the Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity.
Results
The Cronbach’s alpha coefficient was 0.797, and the ICC was 0.887. Spearman’s rank correlation analysis revealed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively).
Conclusion
Our results demonstrate that the K-SCOPA-Cog has good reliability and validity.
Original Article
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Comparative Olfactory Profiles in Parkinson’s Disease and Drug-Induced Parkinsonism
In Hee Kwak, Young Eun Kim, Suk Yun Kang, Joong Seob Lee, Jeongjae Lee, Min Seung Kim, Dong A Yea, Hyeo-il Ma
J Mov Disord. 2024;17(1):64-70.   Published online October 6, 2023
DOI: https://doi.org/10.14802/jmd.23105
  • 1,990 View
  • 390 Download
AbstractAbstract PDFSupplementary Material
Objective
Drug-induced parkinsonism (DIP) is a frequently encountered diagnostic possibility when considering Parkinson’s disease (PD). While olfactory dysfunction is a common clinical feature in PD, the comparison of olfactory function between the two conditions remains insufficient. This study aimed to compare olfactory function, including threshold, discrimination, and identification (TDI) profiles, between PD and DIP.
Methods
Consecutive patients with drug-naïve PD (n = 78) or DIP (n = 31) confirmed through dopamine transporter imaging were enrolled in this study. The YSK olfactory function (YOF) test, composed of TDI domains culturally familiar odorants to Koreans, was administered to all patients.
Results
In the study population, patients with DIP were significantly older than patients with PD. Over 70% of patients in each group had hyposmia or anosmia, and there was no significant difference in the occurrence of olfactory dysfunction between the two groups. In addition, there were no differences in the total YOF score and threshold score between the two groups. Meanwhile, the PD group had a significantly lower discrimination and identification score than the DIP group after adjusting for age, sex, the existence of diabetes, disease duration, and cognitive function.
Conclusion
This study demonstrated that detailed olfactory profiles are different in PD and DIP, even though olfactory dysfunction can be observed in both conditions.
Review Article
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Evidence of Inflammation in Parkinson’s Disease and Its Contribution to Synucleinopathy
Thuy Thi Lai, Yun Joong Kim, Hyeo-il Ma, Young Eun Kim
J Mov Disord. 2022;15(1):1-14.   Published online November 3, 2021
DOI: https://doi.org/10.14802/jmd.21078
  • 8,911 View
  • 569 Download
  • 15 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Accumulation of alpha-synuclein (αSyn) protein in neurons is a renowned pathological hallmark of Parkinson’s disease (PD). In addition, accumulating evidence indicates that activated inflammatory responses are involved in the pathogenesis of PD. Thus, achieving a better understanding of the interaction between inflammation and synucleinopathy in relation to the PD process will facilitate the development of promising disease-modifying therapies. In this review, the evidence of inflammation in PD is discussed, and human, animal, and laboratory studies relevant to the relationship between inflammation and αSyn are explored as well as new therapeutic targets associated with this relationship.

Citations

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  • Recent advances of nanomaterials for intervention in Parkinson’s disease in the context of anti-inflammation
    Ruoyu Zhang, Xiaotong Chen, Yuanyuan Cheng, Zixuan Chen, Xiaoqiong Li, Yulin Deng
    Coordination Chemistry Reviews.2024; 502: 215616.     CrossRef
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    Thuy Thi Lai, Young Eun Kim, Linh Thi Nhat Nguyen, Tinh Thi Nguyen, In Hee Kwak, Franziska Richter, Yun Joong Kim, Hyeo-il Ma
    npj Parkinson's Disease.2024;[Epub]     CrossRef
  • New Insights into Oxidative Stress and Inflammatory Response in Neurodegenerative Diseases
    Eveljn Scarian, Camilla Viola, Francesca Dragoni, Rosalinda Di Gerlando, Bartolo Rizzo, Luca Diamanti, Stella Gagliardi, Matteo Bordoni, Orietta Pansarasa
    International Journal of Molecular Sciences.2024; 25(5): 2698.     CrossRef
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    Tatsuhiro Terada, Tomoyasu Bunai, Takanori Hashizume, Takashi Matsudaira, Masamichi Yokokura, Hirotsugu Takashima, Takashi Konishi, Tomokazu Obi, Yasuomi Ouchi
    Scientific Reports.2024;[Epub]     CrossRef
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    Saeed Mohammad Soleymani, Farhad Assarzadegan, Seyed Amir Hassan Habibi, Arash Mahboubi, Hadi Esmaily
    Parkinsonism & Related Disorders.2024; 126: 107051.     CrossRef
  • Atractylenolide-I Ameliorates Motor Deficits and Reduces Inflammation of the Spinal Cord by SIRT1/PGC-1α Pathway in MPTP Subacute Mouse Model of Parkinson’s Disease
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    Neuropsychiatric Disease and Treatment.2024; Volume 20: 1919.     CrossRef
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    Kyung Ah Woo, Han-Joon Kim, Chan Young Lee, Jung Hwan Shin, Choonghyun Sun, Hogune Im, Hongyul An, Jiwoo Lim, Su-Yeon Choi, Youngil Koh, Beomseok Jeon
    npj Parkinson's Disease.2024;[Epub]     CrossRef
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    G. V. Idova, E. L. Alperina, S. Ya. Zhanaeva
    Neuroscience and Behavioral Physiology.2023; 53(9): 1534.     CrossRef
  • Vitamin D3 actions on astrocyte cells: A target for therapeutic strategy in Parkinson’s disease?
    Erlânia Alves de Siqueira, Emanuel Paula Magalhães, Ramon Róseo Paula Pessoa Bezerra de Menezes, Tiago Lima Sampaio, Danya Bandeira Lima, Conceição da Silva Martins, Kelly Rose Tavares Neves, Gerly Anne de Castro Brito, Alice Maria Costa Martins, Glauce S
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    Ran Zheng, Yiqun Yan, Shaobing Dai, Yang Ruan, Ying Chen, Chenjun Hu, Zhihao Lin, Naijia Xue, Zhe Song, Yi Liu, Baorong Zhang, Jiali Pu
    Journal of Neuroinflammation.2023;[Epub]     CrossRef
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    Qiu-Qin Han, Weidong Le
    Neuroscience Bulletin.2023; 39(5): 832.     CrossRef
  • The Role of Ubiquitin–Proteasome System and Mitophagy in the Pathogenesis of Parkinson's Disease
    Yu Liang, Guangshang Zhong, Mingxin Ren, Tingting Sun, Yangyang Li, Ming Ye, Caiyun Ma, Yu Guo, Changqing Liu
    NeuroMolecular Medicine.2023; 25(4): 471.     CrossRef
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    Sadegh Moradi Vastegani, Seyed Esmaeil Khoshnam, Samireh Ghafouri, Nima Bakhtiari, Yaghoob Farbood, Alireza Sarkaki, Wesley Lyeverton Correia Ribeiro
    PLOS ONE.2023; 18(11): e0294612.     CrossRef
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    G. V. Idova, E. L. Alperina, S. Ya. Zhanaeva
    Журнал высшей нервной деятельности им. И.П. Павлова.2023; 73(4): 454.     CrossRef
  • A2A Adenosine Receptor Antagonists: Are Triazolotriazine and Purine Scaffolds Interchangeable?
    Andrea Spinaci, Catia Lambertucci, Michela Buccioni, Diego Dal Ben, Claudia Graiff, Maria Cristina Barbalace, Silvana Hrelia, Cristina Angeloni, Seyed Khosrow Tayebati, Massimo Ubaldi, Alessio Masi, Karl-Norbert Klotz, Rosaria Volpini, Gabriella Marucci
    Molecules.2022; 27(8): 2386.     CrossRef
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    Gianluigi Forloni, Pietro La Vitola, Claudia Balducci
    Frontiers in Neuroscience.2022;[Epub]     CrossRef
Original Article
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Patients and Their Caregivers’ Burdens for Parkinson’s Disease in Korea
Jong Sam Baik, Joong-Seok Kim, Seong-Beom Koh, Jin Whan Cho, Phil Hyu Lee, Hyeo-Il Ma, Yun Joong Kim, Tae-Beom Ahn, Sang Jin Kim, Yong Duk Kim, Seong-min Choi, Ho-Won Lee, Hee Tae Kim
J Mov Disord. 2017;10(3):109-115.   Published online September 22, 2017
DOI: https://doi.org/10.14802/jmd.17053
  • 7,764 View
  • 233 Download
  • 12 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Objective
Many patients with Parkinson’s disease (PD) suffer from motor and non-motor symptoms. According to these variable symptoms of PD, patients or caregivers have a poorer quality of life than patients with other neurodegenerative diseases. Since the difficulties are varied for all patients, prioritizing their difficulties differs among all cases. The goal of this study was to investigate the burdens of PD among the caregivers as well as patients and to identify areas requiring aid from the government.
Methods
We surveyed the awareness and perceptions of PD in patients and caregivers of PD by a face-to-face questionnaire. The questionnaire was divided into three sections: symptoms of PD (part A), desire for policies (part B), and difficulties faced by their caregivers (part C). Part A comprised 8 questions, Part B had 2 questions, and Part C had 3 questions.
Results
In total, 853 subjects (702 patients and 151 caregivers) were enrolled in this study. The major difficulties experienced by PD patients were physical (67%), psychiatric (60%) and socio-economic (52%). Assessing the physical difficulties, more than half the patients experienced severe difficulties (29% very severe, 39% severe). Psychiatric difficulties were assessed as severe (35%) and very severe (21%) among the patients. Severe difficulties were also experienced socio-economically, at 52% in patients and 49% in caregivers, especially among patients in their fifties (58%) and those with their spouse (65%) as caregivers. The topmost need was the introduction of new technology for treatment of PD (62%), followed by relief of costs for treatment (38%) and a family support system (31%). The majority (91%) of the patients were diagnosed with PD within two years after onset of symptoms.
Conclusion
We know that the difficulties of PD and the needs for government assistance are different between patients and caregivers. These results emphasize that perceiving the difficulties and needs of patients and caregivers early can help to prevent and ameliorate the burden of disease.

Citations

Citations to this article as recorded by  
  • Challenges in Parkinson’s Disease Care—In Light of the COVID-19 Pandemic
    Kyung Ah Woo, Han-Joon Kim, Beomseok Jeon
    Journal of Movement Disorders.2023; 16(1): 52.     CrossRef
  • Efficacy and safety of a combination of emotional freedom technique with acupuncture versus acupuncture alone to treat psychiatric symptoms in Parkinson’s disease: A protocol for a randomized, assessor-blind, parallel-group clinical trial
    Dong-Hoon Kang, Ju-Yeon Kim, Yang-Chun Park, Ho-Ryong Yoo, In Chul Jung
    Medicine.2023; 102(21): e33714.     CrossRef
  • Exploring Unmet Information Needs of People with Parkinson’s Disease and Their Families: Focusing on Information Sharing in an Online Patient Community
    Hyeon Sik Chu, Hye Young Jang
    International Journal of Environmental Research and Public Health.2022; 19(5): 2521.     CrossRef
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    Marie-Christine Hallé, Charline Delorme, Édith Coulombe, Ouswa Rekik, Ingrid Verduyckt
    Frontiers in Rehabilitation Sciences.2022;[Epub]     CrossRef
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    J. Yoon Irons, Grenville Hancox, Trish Vella-Burrows, Eun-Young Han, Hyun-Ju Chong, David Sheffield, Donald E. Stewart
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    Hanan AboJabel, Einat Argavan, Sharon Hassin-Baer, Rivka Inzelberg, Perla Werner
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Letter to the editor
Article image
Presynaptic Dopaminergic Degeneration in a Patient with Beta-Propeller Protein-Associated Neurodegeneration Documented by Dopamine Transporter Positron Emission Tomography Images: A Case Report
Min Ki Kim, Nan Young Kim, Sangkyoon Hong, Hyeo-Il Ma, Yun Joong Kim
J Mov Disord. 2017;10(3):161-163.   Published online September 12, 2017
DOI: https://doi.org/10.14802/jmd.17044
  • 5,712 View
  • 95 Download
  • 2 Web of Science
  • 3 Crossref
PDF

Citations

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  • Comprehensive analysis of autophagic functions of WIPI family proteins and their implications for the pathogenesis of β-propeller associated neurodegeneration
    Takahiro Shimizu, Norito Tamura, Taki Nishimura, Chieko Saito, Hayashi Yamamoto, Noboru Mizushima
    Human Molecular Genetics.2023; 32(16): 2623.     CrossRef
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    Rachel M. Wise, Annika Wagener, Urban M. Fietzek, Thomas Klopstock, Eugene V. Mosharov, Fabio A. Zucca, David Sulzer, Luigi Zecca, Lena F. Burbulla
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Original Article
Validation of the Korean Version of the Scale for Outcomes in Parkinson’s Disease-Autonomic
Ji-Young Kim, In-Uk Song, Seong-Beom Koh, Tae-Beom Ahn, Sang Jin Kim, Sang-Myung Cheon, Jin Whan Cho, Yun Joong Kim, Hyeo-Il Ma, Mee-Young Park, Jong Sam Baik, Phil Hyu Lee, Sun Ju Chung, Jong-Min Kim, Han-Joon Kim, Young-Hee Sung, Do Young Kwon, Jae-Hyeok Lee, Jee-Young Lee, Ji Sun Kim, Ji Young Yun, Hee Jin Kim, Jin Young Hong, Mi-Jung Kim, Jinyoung Youn, Ji Seon Kim, Eung Seok Oh, Hui-Jun Yang, Won Tae Yoon, Sooyeoun You, Kyum-Yil Kwon, Hyung-Eun Park, Su-Yun Lee, Younsoo Kim, Hee-Tae Kim, Joong-Seok Kim
J Mov Disord. 2017;10(1):29-34.   Published online January 18, 2017
DOI: https://doi.org/10.14802/jmd.16057
  • 16,187 View
  • 375 Download
  • 31 Web of Science
  • 33 Crossref
AbstractAbstract PDFSupplementary Material
Objective
Autonomic symptoms are commonly observed in patients with Parkinson’s disease (PD) and often limit the activities of daily living. The Scale for Outcomes in Parkinson’s disease-Autonomic (SCOPA-AUT) was developed to evaluate and quantify autonomic symptoms in PD. The goal of this study was to translate the original SCOPA-AUT, which was written in English, into Korean and to evaluate its reliability and validity for Korean PD patients.
Methods
For the translation, the following processes were performed: forward translation, backward translation, expert review, pretest of the pre-final version and development of the final Korean version of SCOPA-AUT (K-SCOPA-AUT). In total, 127 patients with PD from 31 movement disorder clinics of university-affiliated hospitals in Korea were enrolled in this study. All patients were assessed using the K-SCOPA-AUT and other motor, non-motor, and quality of life scores. Test-retest reliability for the K-SCOPA-AUT was assessed over a time interval of 10−14 days.
Results
The internal consistency and reliability of the K-SCOPA-AUT was 0.727 as measured by the mean Cronbach’s α-coefficient. The test-retest correlation reliability was 0.859 by the Guttman split-half coefficient. The total K-SCOPA-AUT score showed a positive correlation with other non-motor symptoms [the Korean version of non-motor symptom scale (K-NMSS)], activities of daily living (Unified Parkinson’s Disease Rating Scale part II) and quality of life [the Korean version of Parkinson’s Disease Quality of Life 39 (K-PDQ39)].
Conclusion
The K-SCOPA-AUT had good reliability and validity for the assessment of autonomic dysfunction in Korean PD patients. Autonomic symptom severities were associated with many other motor and non-motor impairments and influenced quality of life.

Citations

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  • Baseline prevalence and longitudinal assessment of autonomic dysfunction in early Parkinson’s disease
    Lanqing Yang, Huan Gao, Min Ye
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    Jong Hyeon Ahn, Jin Myoung Seok, Jongkyu Park, Heejeong Jeong, Younsoo Kim, Joomee Song, Inyoung Choi, Jin Whan Cho, Ju-Hong Min, Byoung Joon Kim, Jinyoung Youn, Antonina Luca
    PLOS ONE.2021; 16(10): e0258897.     CrossRef
  • Cardiac Autonomic Dysfunction Is Associated with Severity of REM Sleep without Atonia in Isolated REM Sleep Behavior Disorder
    Sooyeoun You, Kyoung Sook Won, Keun Tae Kim, Hyang Woon Lee, Yong Won Cho
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    Frontiers in Aging Neuroscience.2021;[Epub]     CrossRef
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Letter to the editor
Article image
Metronidazole-Induced Craniocervical Myoclonus with Reversible Bilateral Dentate Nucleus Lesions
Hyun Chang Lee, Young Eun Kim, Hyeo-Il Ma
J Mov Disord. 2017;10(1):67-68.   Published online January 18, 2017
DOI: https://doi.org/10.14802/jmd.16021
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PDF

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  • Metronidazole-induced encephalopathy: a systematic review
    Caspar Godthaab Sørensen, William Kristian Karlsson, Faisal Mohammad Amin, Mette Lindelof
    Journal of Neurology.2020; 267(1): 1.     CrossRef
  • Persistent dystonia and basal ganglia involvement following metronidazole induced encephalopathy
    Abdolmajid Omrani, Mohammad Rohani, Sareh Hosseinpour, Ali Reza Tavasoli
    Neurological Sciences.2020; 41(4): 957.     CrossRef
Original Articles
Article image
N30 Somatosensory Evoked Potential Is Negatively Correlated with Motor Function in Parkinson’s Disease
Suk Yun Kang, Hyeo-Il Ma
J Mov Disord. 2016;9(1):35-39.   Published online January 25, 2016
DOI: https://doi.org/10.14802/jmd.15038
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AbstractAbstract PDF
Objective
aaThe aim of this study was to investigate frontal N30 status in Parkinson’s disease (PD) and to examine the correlation between the amplitude of frontal N30 and the severity of motor deficits.
Methods
aaThe frontal N30 was compared between 17 PD patients and 18 healthy volunteers. Correlations between the amplitude of frontal N30 and the Unified Parkinson’s Disease Rating Scale (UPDRS) motor score of the more severely affected side was examined.
Results
aaThe mean latency of the N30 was not significantly different between patients and healthy volunteers (p = 0.981), but the mean amplitude was lower in PD patients (p < 0.025). There was a significant negative correlation between the amplitude of N30 and the UPDRS motor score (r = -0.715, p = 0.013).
Conclusions
The frontal N30 status indicates the motor severity of PD. It can be a useful biomarker reflecting dopaminergic deficits and an objective measurement for monitoring the clinical severity of PD.

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  • A Comparison of Sensorimotor Integration and Motor Fitness Components between Collegiate Athletes with and without Long COVID: A Cross-Sectional Study with Pair-Matched Controls
    Ibrahim M. Moustafa, Amal Ahbouch, Raheesa P. Kader, Tamer Mohamed Shousha, Abdulla Alrahoomi
    Journal of Clinical Medicine.2024; 13(9): 2469.     CrossRef
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    Muhammad Samran Navid, Imran Khan Niazi, Kelly Holt, Rasmus Bach Nedergaard, Imran Amjad, Usman Ghani, Nitika Kumari, Muhammad Shafique, Jenna Duehr, Robert J. Trager, Heidi Haavik
    Journal of Integrative Neuroscience.2024;[Epub]     CrossRef
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    Min Seung Kim, Jaeho Kim, Suk Yun Kang
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    Ryoji Naganuma, Ichiro Yabe, Megumi Takeuchi, Kirari Morishita, Shingo Nakane, Ryoken Takase, Ikuko Takahashi-Iwata, Masaaki Matsushima, Mika Otsuki, Hideaki Shiraishi, Hidenao Sasaki, Wing-ho Yung
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    Sébastien Ditcharles, Eric Yiou, Arnaud Delafontaine, Alain Hamaoui
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Article image
Current Status of Huntington’s Disease in Korea: A Nationwide Survey and National Registry Analysis
Hyun Sook Kim, Chul Hyoung Lyoo, Phil Hyu Lee, Sang Jin Kim, Mee Young Park, Hyeo-Il Ma, Jae Hyeok Lee, Sook Kun Song, Jong Sam Baik, Jin Ho Kim, Myung Sik Lee
J Mov Disord. 2015;8(1):14-20.   Published online January 31, 2015
DOI: https://doi.org/10.14802/jmd.14038
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AbstractAbstract PDF
Objective Huntington’s disease (HD) is a rare neurological disorder, and its current status in Korea is not well investigated. This study aims to determine the prevalence and incidence of HD and to investigate the clinical features of HD patients in Korea.
Methods We estimated the crude prevalence and annual incidence of HD based on the databases of the Rare Diseases Registry (RDR) and the National Health Insurance (NHI). The clinical data of genetically confirmed HD patients was collected from 10 referral hospitals and analyzed.
Results The mean calculated annual incidence was 0.06 cases per 100,000 persons, and the mean calculated prevalence was 0.38 based on the NHI database. The estimated crude prevalence based on the RDR was 0.41. Of the sixty-eight HD patients recruited, the mean age of onset was 44.16 ± 14.08 years and chorea was most frequently reported as the initial symptom and chief complaint. The mean CAG repeat number of the expanded allele was 44.7 ± 4.8 and correlated inversely with the age of onset (p < 0.001). About two-thirds of the patients have a positive family history, and HD patients without positive family history showed a delay in onset of initial symptoms, a prolonged interval between initial symptom onset and genetic diagnosis and a delay in the age of genetic diagnosis.
Conclusions To the best of our knowledge, this is the first study to estimate the prevalence and incidence of HD in Korea and the largest HD series in the Asian population. Our analyses might be useful for further studies and large-scale investigations in HD patients.

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Case Report
A Case of Painful Hemimasticatory Spasm with Masseter Muscle Hypertrophy Responsive to Botulinum Toxin
Jin-Hyuck Kim, Seok-Won Han, Yun Joong Kim, Jooyong Kim, Mi-Suh Oh, Hyeo-Il Ma, Byung-Chul Lee
J Mov Disord. 2009;2(2):95-97.
DOI: https://doi.org/10.14802/jmd.09026
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AbstractAbstract PDF

Hemimasticatory spasm (HMS) is a rare disorder of the trigeminal nerve characterized by paroxysmal involuntary contractions of the unilateral jaw-closing muscles. HMS has been frequently described in association with facial hemiatrophy or localized scleroderma. A 42-year-old female presented with involuntary paroxysmal spasms of the left face, of 6 months duration. Her lower face on the left was markedly hypertrophied without skin lesions. An electrophysiological study indicated that the masseter reflexes and masseteric silent period were attenuated on the affected side. Surface electromyography demonstrated irregular bursts of motor unit potentials at high frequencies up to 200 Hz. Magnetic resonance imaging of the head showed marked hypertrophy of the left masseter muscle. Biopsy of the hypertrophied masseter muscle was normal. Repeated local injections of botulinum toxin noticeably reduced the size of the hypertrophied muscle as well as improved the patient’s symptoms.

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