The use of botulinum toxin type A for the treatment of facial spasm.

We describe our experience with the use of botulinum A toxin for the treatment of patients with facial spasms. Thirty four patients with blepharospasm, thirty eight with hemifacial spasms and three with spastic entropion were injected with the use of Botulinum A toxin. Length of follow up ranged from 6 to 60 months. The effect of toxin lasted an average of 12.1 weeks in patients with blepharospasm and 15.5 weeks in patients with hemifacial spasms. This difference in mean response was statistically significant (p = 0.0001). The most common side effect was ptosis and dry eyes. All side effects were transient in nature, lasting between three and twelve weeks. Botulinum toxin type A injections represent a good alternative for the treatment of facial spasms. It is a safe and effective office procedure. Most patients tolerate the procedure well. Its principal drawback is its transient effect and the need for repeated injections.