Botulinum toxin-A for the treatment of hemifacial spasm.

Management of hemifacial spasm can actually be done medically, surgically and with Botulinum-A Toxin. The Botulinum-A Toxin treatment locally injected into the involved facial muscles offers a useful alternative to medical and surgical therapy. The objective of this study was to evaluate the efficacy of Botulinum-A Toxin for the treatment of hemifacial spasm in those subjects for whom the presently available medical therapy is inadequate. A total of 28 individuals were enrolled in the clinical study. Patients were evaluated using the Fahn's blepharospasm rating and disability scales. Efficacy was assessed by evaluating changes from the baseline in eyelid spasm intensity, brow spasm intensity, eyelid force and facial spasm intensity. All 28 subjects with hemifacial spasm showed clinical improvement in relation to this baseline, which was statistically significant. The mean decrease from baseline at their follow-up examination was statistically significant for all subjects and for all measurements: eyelid spasm changed from 2.3 to 0.3 (p = 0.0001); brow spasm from 1.9 to 0.1 (p = 0.0001); facial spasm from 2.3 to 0.1 (p = 0.0001) and eyelid force from 0.9 to -0.1 (p = 0.0020). We concluded that Botulinum-A Toxin provides a significant therapeutic benefit to patients with hemifacial spasm, without the risk of disabling side effects.