Objective: To analyze the demographic characteristics of patients with HFS and their response to different BoNT at the center for movement disorders CETRAM in Santiago, Chile.

Background: Hemifacial spasm (HFS) is a neurological disorder characterized by involuntary contractions of the muscles on one side of the face (i.e., myoclonus). The condition is primarily idiopathic or rarely secondary to causes like facial nerve compression. HFS can significantly disturb the quality of life and interfere with daily activities. Botulinum neurotoxin (BoNT) is the first-line treatment for HFS.

Method: A retrospective study was conducted on patients with HFS seen at CETRAM between January 2022 and March 2023.

Results: Two hundred eighty-seven patients (women 74%) with HFS were identified. The average time since the beginning of symptoms was 8 to 9 years. A minority had secondary causes. Post-paralytic HFS commences between 1 to 15 months after facial palsy. Vessels contacting the facial nerve were identified in a small proportion. We identified a few familial cases (first-degree family history of HFS) and bilateral HFS. Neurocysticercosis and ependymomas were rare secondary etiologies. Parkinson’s disease was an occasional comorbidity—the meantime since the first BoNT injection was 5.5 years. Seven patients refused the use of botulinum neurotoxin (BoNT), six citing cost, and 1 expressing fear of injections as the reason for refusal. Most were treated with Onabotulinum toxin A (with doses ranging from 10 to 50 IU), followed by Incobotulinum toxin A and the strain CBFC26. There was no difference in BoNT dosage by age, sex, family history, or the age of onset. A history of facial paralysis and the duration of illness appears as dose modifiers. Most patients did not experience complications. The frequency of exchange between toxins, patients´ preferences, the time to effect initiation, effect duration, and data on quality of life will be presented in the poster.

Conclusion: BoNT is an effective and safe treatment for managing HFS. All Ona, Inco, and CBFC26 botulinum toxins A are effective treatments. A history of facial paralysis and disease duration are dose modifiers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hemifacial-spasm-recent-experience-in-a-movement-disorders-reference-center-in-chile/