Botulinum toxin injections for the treatment of hemifacial spasm over 16years

Sorgun, Mine Hayriye; Yılmaz, Rezzak; Akin, Yusuf Alper; Mercan, Fatma Nazli; Akbostancı, Muhittin Cenk

doi:10.1016/j.jocn.2015.02.032

Cited by 27 publications

(20 citation statements)

References 56 publications

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“…The results reported here are supported by Sorgun et al, reporting on a meta-analysis of BT therapy for HFS. 70 They found that 94.3% of patients experienced an 86.7% improvement in symptoms, adverse events occurred in 2.3%-22.1% of injections, and the average duration of therapy was 15.7 weeks. Although BT injections boast a very high response rate, Hsiung et al reported primary and secondary resistance rates of 2.9% and 4.3%, respectively.…”

Section: Comparative Treatmentsmentioning

confidence: 97%

“…The percent of injections resulting in an adverse reaction was 16% (95% CI 8-25, p < 0.001, I 2 0.83). 4,36,66,70,73 All report-ed complications were transient. The most commonly reported complications included ptosis, diplopia, and facial weakness.…”

Section: Treatment Of Hfs With Btmentioning

confidence: 98%

“…2,4,10,12,21,55,69,72,73,84 The mean peak symptom improvement as subjectively reported was 77% (95% CI 74-81, p = 0.380, I 2 0.06). 2,14,25,36,65,66,70,72,81 Complication rates were inconsistently reported. The percent of injections resulting in an adverse reaction was 16% (95% CI 8-25, p < 0.001, I 2 0.83).…”

Section: Treatment Of Hfs With Btmentioning

confidence: 99%

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An investigation into quality of life improvement in patients undergoing microvascular decompression for hemifacial spasm

Lawrence

Frederickson

Chang

et al. 2018

Journal of Neurosurgery

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OBJECTIVE Hemifacial spasm (HFS) is a movement disorder characterized by involuntary spasms of the facial muscles, and it can negatively impact quality of life (QOL). This retrospective study and systematic review with meta-analysis was conducted to investigate the QOL in patients with HFS following intervention with microvascular decompression (MVD) and botulinum toxin (BT). METHODS In the retrospective analysis, a QOL questionnaire was administered to all patients undergoing MVD performed by a single surgeon. The QOL questionnaire included unique questions developed based on the authors' experience with HFS patients in addition to the health-related QOL HFS-8 questionnaire. The authors also report on a systematic review of the English literature providing outcomes and complications in patients with HFS undergoing treatment with either MVD or BT. RESULTS Regarding the retrospective analysis, 242 of 331 patients completed the questionnaire. The mean score of the 10 QOL questions improved from 22.78 (SD 9.83) to 2.17 (SD 5.75) following MVD (p < 0.001). There was significant improvement across all subscales of the questionnaire between pre- and postoperative responses (p < 0.001). Regarding the systematic review, it is reported that approximately 90% of patients undergoing MVD for HFS experience a complete recovery from symptoms, whereas the mean peak improvement of symptoms following treatment with BT is 77%. Furthermore, patients undergoing MVD reported a greater improvement in the mean supplemental index of QOL as compared with patients receiving BT therapy. CONCLUSIONS Microvascular decompression offers a significant improvement in QOL in well-selected patients suffering from HFS, and may offer an increased benefit for QOL over BT injections.

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Section: Comparative Treatmentsmentioning

confidence: 97%

Section: Treatment Of Hfs With Btmentioning

confidence: 98%

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An investigation into quality of life improvement in patients undergoing microvascular decompression for hemifacial spasm

Lawrence

Frederickson

Chang

et al. 2018

Journal of Neurosurgery

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“…Defazio et al found that the percentage of side effects was be related to dosage. Cakmur et al reported higher success rates, longer durations of improvement, and fewer side effects with pretarsal injections [4,9,11,12].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic assisted microvascular decompression versus new antiepileptics and BOTOX in treatment of hemifacial spasm: a clinical trial

et al. 2020

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Introduction: Hemifacial spasm (HFS) is a chronic movement disorder characterized by twitching of muscles of facial expression which is innervated by the facial nerve. The condition is unilaterally, beginning in the orbicularis occuli, and later on progress to involve the perioral, platysma, and other muscles of facial expression. Endoscopic assisted microvascular decompression is considered the state of the art in hemi-facial spasm surgery. New antiepileptic have emerged with a new hope for good control with few side effects. Botulinum toxin is still a good option for some patients. Methods: This study is a prospective study that was conducted on 30 patients with primary hemifacial spasm. Bilateral and secondary cases where excluded. All patients were subjected to proper pre-treatment assessment including; proper history taking, clinical examination, and proper radiological investigations (MRI, FISTA) when needed. They were divided into three groups according to treatment modality: group A where patient's general condition was unfit for surgical intervention, received oral medications (gabapentin or levetiracetam); group B included those patients unfit for surgical intervention and did not respond to oral therapy, received Botox injection; and group C underwent endoscopic assisted microvascular decompression. Follow-up period ranged from 6 to 24 months. Outcome of different treatment modalities were compared among different groups. Results: Among group A patients, one patient showed excellent response to treatment (Gabapentin 1200 mg), three patients had good response, four patients had fair response, and three patients had poor response to treatment (one used levetiracetam, two used gabapentin). Overall success rate is 72.7%. Among group B patients, four patients enjoyed excellent response. Another four patients had good response, while three patients had fair response. Only one patient had poor response. Overall success rate was 83.3%. Among group C patients, five cases had excellent outcome and two cases had good outcome. Overall success rate is 100%. Conclusion: Endoscopic assisted microvascular decompression offers the best chance to permanent cure with low complication rate. New antiepileptics (levetiracetam, gabapentin) provide a safe therapy for patients refusing surgical intervention. Botox is an attractive local therapy with reversible complications but with non-sustainable effect. From our results, we conclude that endoscopic assisted microvascular decompression is superior to either BOTOX or antiepiletics for the permanent cure of hemifacial spasm.

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“…IncoBoNT-A and onaBoNT-A are typically diluted to a concentration of 5 U/0.1 cc; aboBoNT-A to 20 U/0.1 cc. 22,39,79 A single study comparing dilutions of 5 U/0.1 cc and 2.5 U/0.1 cc onaBoNT-A for HFS showed a longer duration for the more concentrated injectate, but more pronounced and longer lasting weakness. 80…”

Section: Doses/toxin Selectionmentioning

confidence: 99%

Botulinum Toxin Treatment of Blepharospasm, Orofacial/Oromandibular Dystonia, and Hemifacial Spasm

Karp

Alter

2016

Semin Neurol

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Blepharospasm is a focal dystonia characterized by involuntary, repetitive eye closure. Orofacial and oromandibular dystonia describe involuntary dystonic movements of orofacial and oromandibular musculature. Hemifacial spasm is characterized by repetitive synchronous contraction of facial nerve innervated muscles on one side of the face. In this article, the clinical presentation, epidemiology, and approaches to treatment are reviewed. Technical aspects of using botulinum toxin for treatment and reported outcomes are discussed.

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Botulinum toxin injections for the treatment of hemifacial spasm over 16years

Cited by 27 publications

References 56 publications

An investigation into quality of life improvement in patients undergoing microvascular decompression for hemifacial spasm

An investigation into quality of life improvement in patients undergoing microvascular decompression for hemifacial spasm

Endoscopic assisted microvascular decompression versus new antiepileptics and BOTOX in treatment of hemifacial spasm: a clinical trial

Botulinum Toxin Treatment of Blepharospasm, Orofacial/Oromandibular Dystonia, and Hemifacial Spasm

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