{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:08:07Z","timestamp":1792786087517,"version":"4.5.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior-Brasil","id":[{"id":"https:\/\/ror.org\/00x0ma614","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence and clinical characteristics of facial pain in patients with primary hemifacial spasm (HFS), identify factors associated with its occurrence, and evaluate its longitudinal course after botulinum toxin type A (BoNT-A) treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study with 4\u2009months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary public referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Eighty-seven adults with primary HFS receiving BoNT-A treatment. Median age was 66\u2009years, 71.3% were women, and median disease duration was 13\u2009years (interquartile range [IQR] 8\u201320).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants underwent standardized assessment that included a semistructured questionnaire, visual analog scale, McGill Pain Questionnaire, facial pain diary, Hospital Anxiety and Depression Scale, and Hemifacial Spasm Grading Questionnaire. Clinical characteristics and factors associated with facial pain were analyzed, and pain outcomes were assessed longitudinally after BoNT-A treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Facial pain was present in 40.2% of patients, predominantly involving the periorbital region (77.1%) and occurring ipsilateral to the spasm (85.7%). Median pain frequency was 5\u2009days\/month (IQR 3\u201315), median intensity was 6\/10 (IQR 5\u20138), and median duration was 5\u2009hours (IQR 1\u201320). In multivariable analysis, facial pain was independently associated with female sex (odds ratio [OR] 3.47, 95% confidence interval [CI] 1.00\u201311.97; P\u2009=\u2009.049) and greater subjective disease burden, measured by the HFS Global Subjective score (OR 1.01, 95% CI 1.00\u20131.03; P\u2009=\u2009.034), but not with objective motor severity. Although 88.2% of patients reported subjective improvement after BoNT-A, objective pain measures remained unchanged during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Facial pain is a frequent non-motor manifestation of HFS, affecting approximately 40% of patients. Its association with greater subjective disease burden, but not objective motor severity, suggests that pain represents a clinically relevant dimension of HFS not captured by motor assessment alone. Routine assessment of facial pain should therefore be incorporated into the comprehensive clinical evaluation of patients with HFS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnag119","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:38:59Z","timestamp":1788867539000},"source":"Crossref","is-referenced-by-count":0,"title":["Facial pain in patients with hemifacial spasm: a prospective cohort study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3725-4464","authenticated-orcid":false,"given":"Miriam","family":"Carvalho Soares","sequence":"first","affiliation":[{"name":"Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE) , Recife, Pernambuco,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"de Almeida Cruz Silva","sequence":"additional","affiliation":[{"name":"Scientific Initiation Fellowships 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