Session Information
Date: Thursday, June 8, 2017
Session Title: Other
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: To evaluate the presence of possible clinical differences between patients with HS with and without neurovascular conflict (NVC +, NVC-) and their therapeutic response to infiltration with botulinum toxin type A (onabotulinumtoxin A) (BTX).
Background: Hemifacial spasm (HS) is an involuntary, intermittent, and irregular clonic contraction of the muscles innervated by the facial nerve. It has been more frequently attributed to the presence of a direct contact between the facial nerve and an ectopic vascular anatomical structure or other pathological process, although this association has not been demonstrated in all patients.
Methods: We included all patients with HS who received treatment with BTX in our Movement Disorders Section in the period 2015-2016.
Age, sex, evolution time, severity, BTX units, duration of the effect and postinfiltration complications were evaluated.
Results: Patients with HS treated with BTX: 39; CNV-: 19; NVC +: 20. Average age (years): NVC-: 64.2±13 vs NVC +: 63±16 (p0.79). Female gender: NVC-: 66.6% vs. NVC +: 66.6% (p0.68). Time of evolution (years): NVC-: 9.4±7 vs NVC +: 5.4±4.6 (p0.04). Severity (Martí-Tolosa Scale): NVC-: 15.3±4.5 vs NVC +: 16.9±5.2 (p0.32). BTX units: NVC: 36.8±6 vs NVC +: 33.3±7.2 (p0.1). Duration of the effect (months): NVC-: 4±1.6 vs NVC +: 4.2± .5 (p0.84). Infiltrations per year: NVC-: 2±1 vs NVC +: 2.2± .2 (p0.61). Adverse effects: 48% vs 52% (p0.21).
Conclusions: In our group of patients, there were no significant demographic or clinical differences between HS NVC + and NVC -, except in the time of evolution until the treatment. The effect of BTX, its dose, its duration, and the rate of adverse effects did not differ in both groups. Our data suggest that the therapeutic approach with BTX should not differ according to the presence or not of NVC.
References: 1.Safety and efficacy of botulinum toxin in hemifacial spasm.Mazlout H, Kamoun Gargouri H, Triki W, Kéfi S, J Fr.J Fr Ophtalmol. 2013 Mar;36(3):242-6
2.Hemifacial spasm: clinical findings and treatment.Wang A , Jankovic J.Muscle Nerve. 1998 Dec;21(12):1740-7
To cite this abstract in AMA style:
J.S. Bestoso, L. Ciancaglini, C. Stefani, C. Azcona, M.L. Contartese, A. Pappolla, J.I. Rojas, D. Bauso. Differences between Hemifacial spasm with or without neurovascular conflict. Therapeutic implications with botulinum toxin type A. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/differences-between-hemifacial-spasm-with-or-without-neurovascular-conflict-therapeutic-implications-with-botulinum-toxin-type-a/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/differences-between-hemifacial-spasm-with-or-without-neurovascular-conflict-therapeutic-implications-with-botulinum-toxin-type-a/