Orofacial movements are often outward manifestations of many generalized organic processes. When muscle weakness and hyperactivity are present, tumors and lesions at the base of the skull should be ruled out. Treatments involving myotomies and denervations are drastic, but can be effective even if disfiguring. Botulinum toxin offers short-term (weeks to months) relief, and when used sparingly the muscles involved are only modestly impaired. Since the etiology of many of these movements is unknown, treatments are usually only palliative and remissions rare.