Objective: To describe efficacy and side effects in the long term treatment of hemifacial spasm and blepharospasm with botulinum toxin type A.
Material and Methods: All patients with hemifacial spasm and blepharospasm injected with botulinum toxin type A (BotoxR) for at least one year or at least three injections were included. The efficacy was assessed and reported in terms of peak improvement (0-100%), a 6-point disability score and duration of response. Side effects were recorded in all treatments.
Results: A total of 521 and 289 treatments were injected in 45 patients with HFS and 20 patients with BS respectively. Peak improvement and duration of response of HFS and BS were 92% and 17.3 weeks, and 91% and 16.1 weeks, respectively. Compared with the baseline score, the disability score indicated a significant improvement for the HFS and BS patients. All patients responded to the treatment in this study. Side effects occurred in only 5.4% and 2.1% of all treatments for HFS and BS, respectively. The most common side effect was facial paresis (5%) for HFS and ptosis (1%) for BS. All side effects were mild and transient, lasting from 1-4 weeks after injection.
Conclusion: Botulinum toxin type A is an effective treatment for all patients with hemifacial spasm and blepharospasm in the long term. Side effects are lower when compared to other studies in Thailand.