Session Information
Date: Monday, September 23, 2019
Session Title: Other
Session Time: 1:45pm-3:15pm
Location: Agora 2 West, Level 2
Objective: To analyze the causes of hemifacial spasm as well as the efficacy and safety of long term treatment with botulinum toxin (BT).
Background: Hemifacial spasm is an uncommon movement disorder characterized by involuntary, unilateral, irregular, tonic or clonic contractions of muscles innervated by the facial nerve, usually starting around the eyes before progressing inferiorly to the cheek, mouth, and neck.
Method: We developed a retrospective study of patients with a diagnosis of hemifacial spasm treated with BT in our center from 1993 to 2018. Demographic (age, sex) and etiological variables as well as doses and number of sessions of BT, infiltrated muscles, therapeutic response according to the Patient Global Impression of Change Scale (PGIC), side effects and adjuvant treatments were analyzed. In addition, these variables were compared according to the etiology (idiopathic or secondary).
Results: From the total of 125 patients studied, 92 (73.6%) were women with a mean age at the start of treatment of 58.63 years (SD 15.4, range 21-91). The cause was idiopathic in 80 patients (64%), finding underlying structural abnormalities in the remaining 36%. Of them, 48.8% were associated with facial paralysis, 40.2% due to vascular alterations, 6.6% with a tumor origin and 4.4% appeared in patients with Parkinson disease. A higher total dose per session was observed in the secondary group. 32 patients (27%) had side effects being transient ptosis and facial hematoma the most common of these. PGIC showed a “very much improved” or “much improved” result in 84.5%. 16 patients (12.8%) required pharmacological concomitant treatment.
Conclusion: A complete etiological diagnosis is essential in patients with hemifacial spasm due to the significant number of cases with underlying structural abnormalities found in our study. In addition, the existence of a known cause could be associated with greater doses of BT to achieve a good response. Regardless of the etiology, long term treatment with BT in hemifacial spasm is safe and effective.
To cite this abstract in AMA style:
Y. Herrero-Infante, A. Rodriguez-Sanz, J. Mañez-Miró, F. Vivancos-Matellano. Hemifacial spasm management: 26-year experience [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/hemifacial-spasm-management-26-year-experience/. Accessed May 16, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/hemifacial-spasm-management-26-year-experience/