Objective: To describe prolonged improvement in patients with involuntary facial and cervical movements after BTX-A therapy.
Background:
Botulinum toxin type A (BTX-A) treatment is considered symptomatic treatment, providing 3–6 months of relief by blocking acetylcholine release before reinjection.
Method: We retrospectively reviewed charts of 10 patients treated at the Movement Disorders Clinics of Tel Aviv Medical Center and Shaare Zedek Medical Center. Mean age at onset was 56.1 years (range 38–79); five female. Diagnoses included hemifacial spasm (n = 3), blepharospasm (n = 5), orofacial dyskinesia (n = 1) and facial myokymia (n = 1). BTX-A preparations were onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA. Functional neurological disorder was considered and judged unlikely in all cases, especially for the facial myokymia patient.
Results:
Maximum equivalent BTX-A dose per session was 103.5 U (range 1–600 U) across an average of 12.8 sessions (range 1–25). Injections were stopped in 50 % of patients after 8.2 sessions (range 1–12) due to sustained improvement. Female with facial myokymia achieved complete remission after a single Onab injection. Seven patients later required only annual injections after 6.5 years (range 3–12; mean 14.8 sessions, range 5–25). This retrospective study could not determine the specific effects of the various botulinum toxin A formulations.
Conclusion:
BTX-A may yield lasting remission in selected patients. Such observations warrant further research to predict durable responses and improve long-term personalized care. Creating national BTX-A databases could enhance AI-driven research in this field.
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To cite this abstract in AMA style:
N. Rozenberg, G. Yahalom, D. Segal, L. Barski, V. Livneh, A. Ezra, R. Alcalay, T. Gurevich. Rare Observations of Sustained Symptomatic Improvement with Botulinum Toxin Type A Injections in Facial and Cervical Dystonia: Case Series [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/rare-observations-of-sustained-symptomatic-improvement-with-botulinum-toxin-type-a-injections-in-facial-and-cervical-dystonia-case-series/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/rare-observations-of-sustained-symptomatic-improvement-with-botulinum-toxin-type-a-injections-in-facial-and-cervical-dystonia-case-series/