ABSTRACT

Hemifacial spasm is a focal movement disorder causing intermittent clonic and tonic contraction of the muscles innervated by the facial nerve. It most often begins in the orbicularis oculi unilaterally. The disorder usually spreads to involve the ipsilateral facial musculature. Blepharospasm is a focal dystonia consist of uncontrolled bilateral contraction of the orbicularis oculi causing eyelid closure. Injection of botulinum toxin A is more successful according to medical treatment. We followed our 19 hemifacial spasm and 2 blepharospasm patients (14 male, 7 female, mean age 57 ± 9.8 years) with periodic injections of botulinum exotoxin. The disorders duration was 91.3 ± 68.6 months and the mean duration of toxin injection after first symptom was 38.6 ± 23 months. Interval of toxin injection was 37.6 ± 26 months, mean number of the toxin injection session was 4 ± 3. The mean dosage of toxin injection were 22.3 ± 8.9 U in the first session, 21.6 ± 8.2 U in the 3 rd session and 19 ± 9.8 U in the 6 th session. Before toxin injection, 9 patients had used carbamazepine, 5 patients had used clonazepame and one patient had used biperidene but they hadn't benefited from the medical treatment. Marsden-Lang Cranial Dystonia Scales were 8.2 ± 10.4 before injection, whereas 3 ± 2.8 after injection. Cause of inadequate response to medical treatment, toxin application had become widespread. As a conclusion, in our clinic, the patients achieved significant palliation with periodic injections of botulinum endotoxin.