Aim: We describe a patient with idiopathic hemifacial spasm (HFS) that was responsive to zonisamide treatment.
Methods and results: A 65-year-old woman presented with a 4-year history of left-sided HFS developing gradually, starting from the upper facial muscles. After several analyses, the diagnosis of idiopathic HFS was made, and the clonazepam treatment (0.5 mg every 8 hours) was started, without a complete remission of symptoms. Therefore, zonisamide (150 mg twice a day for a 6-week period) was added, with a complete resolution. The rechallenge with zonisamide after its dechallenge confirmed its effectiveness. During follow-up, the patient remained symptom-free, with no adverse drug reactions.
Conclusions: We suggest that zonisamide could represent a useful therapeutic option in the treatment of idiopathic HFS.