Botulinum Toxin Injections in the Treatment of Blepharospasm, Hemifacial Spasm, and Eyelid Fasciculations

ABSTRACT:Seventy-six patients with blepharospasm (mean age 56.9 years) received 248 injection treatments with botulinum A exotoxin (mean 3.1 treatments per patient): 87.0% of treatments led to total relief of spasms for a mean interval of 14.1 weeks. The average duration of response remained fairly constant over the first six injection series, although patients with the most severe spasms had shorter intervals than patients with less severe symptoms. Twenty patients with hemifacial spasm (mean age 56.9 years) received 44 treatments (mean 1.9 treatments per patient): In 93.1% of cases there was total relief of periocular and perioral spasms, with a mean interval of 17.4 weeks. The average duration of response for the third series of treatments was much shorter than the mean durations for the first two treatments. Side effects were always transient and included ptosis (23.3%), dry eyes (18.1%), tearing (5.5%), and strabismus (1.4%). No patient had a systemic reaction to the drug. Chronic benign eyelid fasciculations were also successfully treated in 3 patients with single treatments.

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Dry Needling Can Be An Alternative Treatment for Hemifacial Spasm

Biomedical Journal of Indonesia: Jurnal Biomedik Fakultas Kedokteran Universitas Sriwijaya ◽

10.32539/bji.v6i2.11802 ◽

2020 ◽

Vol 6 (2) ◽

pp. 20-28

Author(s):

Selly Marisdina ◽

Henry Sugiharto ◽

A Pradian

Keyword(s):

Botulinum Toxin ◽

Hemifacial Spasm ◽

Alternative Treatment ◽

Epidemiological Data ◽

Clinical Severity ◽

Decompression Surgery ◽

Dry Needling ◽

Significant Difference ◽

Microvascular Decompression Surgery ◽

Botulinum Toxin Injections

Back Ground: Hemifacial spasm is one of movement disorder case that commonly found in daily clinical practice. Epidemiological data are very limited, the average prevalence is 11 per 100,000 population, 14.5 per 100,000 in women and 7.4 per 100,000 in men. In Germany, the estimated prevalence is 8000 to 9000 peoples.1 The incidence of women is more than that of men with a ratio of 2:1. Based on Yaltho and Jankovic study in 2011, out of 215 patients, the ratio of men to women was 1:1.8.2 One study in Indonesia also reported that most of the subjects were female (64.7%).3 Treatment with botulinum toxin injections is preferred to microvascular decompression surgery therapy, but this injection is only effective in a few months and quite expensive. This study is the first study to assess the effectiveness of dry needling on clinical improvement of hemifacial spasm compared to standard therapy of botulinum toxin injection.Methods: The study design was quasi experimental. Total of 24 subjects were divided into two groups. The first group underwent dry needling intervention while the other had botulinum injection. Clinical severity before and after treatment in both groups was assessed using Jankovic and HFS7 scores.Results: In dry needling group there were significant differences between Jankovic and HFS7 score at baseline and at week 1, 2, 3 and 4. While in botox group significant differences were also Jankovic and HFS7 score at baseline and at weeks 2 and 4. There were also a significant difference of Jankovic and HFS7 score when we compared dry needling group to botulinum toxin group.Conclusion: Dry needling can be an alternative treatment for hemifacial spasm, although clinical improvements based on Jankovic and HFS7 scores in dry needling group were not as effective as those with botulinum toxin injections.

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Side Effects of the Use of Botulinum Toxin for Treatment of Benign Essential Blepharospasm and Hemifacial Spasm

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/1542-8877-19900501-08 ◽

1990 ◽

Vol 21 (5) ◽

pp. 335-338

Author(s):

Hanspreet K Kalra ◽

Elbert H Magoon

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Hemifacial Spasm ◽

Essential Blepharospasm

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Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

The Scientific World JOURNAL ◽

10.1155/2014/327928 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Jae Wook Kim ◽

Jae Hong Park ◽

Ki Nam Park ◽

Seung Won Lee

Keyword(s):

Botulinum Toxin ◽

Treatment Efficacy ◽

Botulinum Toxin Injection ◽

Spasmodic Dysphonia ◽

Total Dosage ◽

Adductor Spasmodic Dysphonia ◽

Prospective Comparative Study ◽

The Mean ◽

Botulinum Toxin Injections ◽

The Voice

Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group).Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection.Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration.Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

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Outcome of Injection Botulinum Toxin in Blepharospasm

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.30589 ◽

2021 ◽

Vol 13 (1) ◽

pp. 40-49

Author(s):

Malita Amatya ◽

Ben Limbu ◽

Purnima Rajkarnikar ◽

Hom Bahadur Gurung ◽

Rohit Saiju

Keyword(s):

Botulinum Toxin ◽

Hemifacial Spasm ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Line Treatment ◽

First Line ◽

Essential Blepharospasm ◽

Meige Syndrome ◽

The Mean ◽

First Line Treatment

Introduction: Blepharospasm is a condition of involuntary spasm of the orbicularis oculi muscle which leads to intermittent or complete closure of the eyelids. Botulinum toxin is the currently recommended first line treatment for such blepharospasm. This study aims to find out the outcome of injection Botulinum toxin Type A in Blepharospasm. Materials and methods: It was a hospital based, prospective, interventional study conducted on patients diagnosed as Benign essential blepharospasm (BEB), Meige syndrome (MS) and Hemifacial spasm (HFS) by oculoplastic surgeon at Oculoplasty department OPD, Tilganga Institute of Ophthalmology, from December 2018 to November 2019. After taking all standard precautions for botulinum toxin injections, 6 to 8 sites for injecting 2.5 to 5 IU of the toxin were given. All the patients were evaluated before and after injections according to Jankovic spasm grading and improvement in functional impairment scale and followed on one week, one month, three month and when the symptoms reappeared. Results: A total of 43 cases which included 32 cases of Benign essential Blepharospasm, 9 Hemifacial spasm and 2 Meige syndrome. The mean Jankovic severity score was 3.51 ± 0.51 (range 3-4). The mean improvement in functional score was 2.60 ± 0.54 (range 1-3), was statistically significant (p-value <0.001).The effective period of injection was 130 ± 20.82 (93 – 189) days.38 patients had repeated injections after reappearance of symptoms. 4 patients had side effects of redness and hematoma at one site. Conclusion: This study concludes that Botulinum toxin type A is effective in the management of Benign essential blepharospasm, Hemifacial spasm and Meige syndrome. This along with a good safety profile justifies its role as a first line treatment therapy in blepharospasm. However, it is a temporary treatment option where the effect lasts for a short period of time and repeated injections are required.

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Interarytenoid botulinum toxin A injection for the treatment of vocal process granuloma

The Journal of Laryngology & Otology ◽

10.1017/s0022215119002159 ◽

2019 ◽

Vol 133 (12) ◽

pp. 1041-1045 ◽

Cited By ~ 1

Author(s):

A-L Hamdan ◽

E Khalifee ◽

H Jaffal ◽

A Ghanem

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Chart Review ◽

Botulinum Toxin A ◽

Retrospective Chart Review ◽

Complete Regression ◽

Partial Regression ◽

Toxin A ◽

Vocal Process ◽

The Mean

AbstractObjectivesTo report on the efficacy and adverse effects of interarytenoid botulinum toxin A injection for the treatment of vocal process granuloma.MethodsA retrospective chart review was conducted of eight patients with vocal process granuloma resistant to anti-reflux therapy who underwent interarytenoid botulinum toxin A injection. The mean dosage of botulinum toxin A injected was 6.56 U.ResultsFifty per cent of patients had complete regression of the lesion and 50 per cent had partial regression. The main side effects were breathiness (n = 4), voice breaks (n = 1) and aspiration (n = 1).ConclusionInterarytenoid botulinum toxin A injection for the treatment of vocal process granuloma is an effective mode of therapy, with transient vocal and swallowing side effects.

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Frequency of obsessive and compulsive symptoms in patients with blepharospasm and hemifacial spasm

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000200004 ◽

2005 ◽

Vol 63 (2a) ◽

pp. 213-216 ◽

Cited By ~ 16

Author(s):

Renato P. Munhoz ◽

Helio A.G. Teive ◽

Marcus V. Della Coletta ◽

Francisco M.B. Germiniani ◽

Fábio M. Iwamoto ◽

...

Keyword(s):

Botulinum Toxin ◽

Facial Nerve ◽

Psychiatric Disorders ◽

Hemifacial Spasm ◽

Structured Interview ◽

Test Results ◽

Scale Scores ◽

Dsm Iv ◽

The Mean ◽

Peripheral Origin

BACKGROND: Blepharospasm (BS) is a form of central focal dystonia recently associated with psychiatric disorders, particularly obsessive and compulsive symptoms. Hemifacial spasm (HFS) represents a focal myoclonus with peripheral origin in the facial nerve. OBJECTIVE: To determine the frequency of obsessive and compulsive symptoms in patients with BS in comparison with patients with HFS. METHODS: 30 patients from each group (BS and HFS) followed by the botulinum toxin clinic at the HC-UFPR were evaluated using a structured interview based on the DSM-IV criteria and the Yale-Brown scale. RESULTS: were compared by the mean two-tailed t test. RESULTS: We found obsessive or compulsive symptoms in 20 (66.6%) patients with BE and 21 (70%) with HFS. Yale-Brown scale scores for each group were higher among BS patients; however, diferences were not statisticaly significant. CONCLUSION: Our study did not show a significant diference in the comparison of the prevalence of obsessive and compulsive symptoms among patients with BS and HFS.

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