Article Text

Download PDFPDF
Recognising hemihypomimia as a mimic of ‘facial weakness’
  1. Oliver Phillips1,
  2. Anelyssa D'Abreu1,
  3. Joseph H Friedman2,
  4. Umer Akbar1
  1. 1 Neurology, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  2. 2 Movement Disorders Program, Butler Hospital, Providence, Rhode Island, USA
  1. Correspondence to Dr Oliver Phillips, Neurology, Brown University Warren Alpert Medical School, Providence, RI 02912, USA; Oliver.W.Phillips{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Case descriptions

Patient A is a 69-year-old man with a 5-year history of progressive right hand then leg tremor, stiffness and slowness with recent diagnosis of Parkinson’s disease (PD) 3 months prior to this encounter. Examination demonstrated unilateral right-sided facial droop at rest largely sparing the upper face and with accompanying decreased right lower facial muscle activation. Unified Parkinson’s Disease Rating Scale motor examination score (UPDRS-III) was 26. UPDRS-III facial expression subscore had decreased from 2 to 1 since starting carbidopa/levodopa 50–200 three times daily 3 months prior.

Similarly, patient B is a 77-year-old woman with a 3-year history of tremor starting in her left hand and a diagnosis of PD since 2017. Examination demonstrated resting unilateral left-sided facial droop involving both …

View Full Text


  • Contributors Each named author has substantially contributed to conducting the underlying research and drafting this manuscript. Additionally, to the best of our knowledge, the named authors have no conflict of interest, financial or otherwise.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.