Misdiagnosis of hemifacial spasm is a frequent event in the primary care setting.

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.