64 DM. presented with these movements. diagnosis and treatment?

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This is involuntary contraction of rt masseter muscle.commonest involuntary movement is a hemifacial spasm But this is not hemifacial spasm.90 % of hemifacial spasm start from the eye& spreading to the facial muscles& the remaining starting from the chin & spreading other muscles. Hemifacial include all the facial muscles supplied by the facial Nerve on the affected side. Here contraction of a group of muscle fibers of a single muscle look like fasciculations. The only investigation I will do an Eeg as part of reassurance.

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Hemifacial dyskinesia. Physiotherapy. Tab Clonazepam 0.25mg TDS. Tab Revocon(Tetrabenazine) 12.5 mg TDS (gradually increase doses every 3-7days,may be allowed 25mg TDS. Inj Botulinum toxin is very effective,but costly.

Thanks Dr Abdul Majeed Sir
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It's hemifacial spasm as rightly indicated by @Dr. Dhanashree P after MRI the management can be done via botulinum toxin under EMG guidance for effectiveness followed by baclofen as maintenance dose.

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Hemifacial spasm - rt side.

Hemifacial spasm.

FINE HOIZONTAL NSTAGMAS

Please check his see u calcium and early morning see u calcitonin levels. It could simply be tetany as well

Idiopathic localized fasciculation ? Myokymia No specific tt.

Fasciculations.no treatment. However do all reqd investigations

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