title: Botulinum toxin improves quality of life in hemifacial spasm: validation of a questionnaire (HFS-30).
abstract: BACKGROUND
  Hemifacial spasm (HFS) can be disabling and affect quality of life. There is a lack of a validated scale for evaluating botulinum toxin (BTX) response in HFS.
  
  
  OBJECTIVE
  We examined the validity and reliability of a self-rating health-related quality of life (HRQOL) questionnaire (HFS-30) in HFS and investigated the correlation of this questionnaire with the neurologists' assessment of severity of HFS and response to botulinum toxin (BTX) treatment.
  
  
  METHODS
  HFS patients were asked to answer a total of 30 self-rating questions divided into seven subscales: Mobility; Activities of Daily Living (ADL); Emotional Well-being; Stigma; Social support; Cognition; and Communication. All of the items were scored on a 5-point scales ranging from 0 ("never") to 4 ("always"). They were also asked to assess their response to the BTX treatment based on a similar questionnaire at 6-8 weeks after BTX. The validity, reliability and sensitivity of the questionnaire were analyzed statistically.
  
  
  RESULTS
  There were 80 HFS patients with mean age of 56.3+/-11.1 (S.D.) years (range 35 to 81), consisting of 54 (67.5%) females, 26 (32.5%) males. The intraclass correlation coefficient (ICC) and Cronbach's alpha were more than 0.7 for the majority of the items and subscales, respectively. There was a good positive correlation of severity of HFS with the subscale scores. Regression analysis of physicians' assessment of response to BTX on change in scores from baseline as rated by patients demonstrated a significant correlation.
  
  
  CONCLUSIONS
  We demonstrated validity, reliability and sensitivity of the HFS-30 questionnaire. BTX improves quality of life in HFS.
authors.affiliation: Department of Neurology and Clinical Research, Singapore General Hospital, Outram Road, Singapore. gnrtek@sgh.com.sg
authors.forename: Eng-King
authors.initials: EK
authors.lastname: Tan
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fook-Chong
authors.forename: Sau-Ying
authors.initials: SY
authors.lastname: Lum
authors.forename: Erle
authors.initials: E
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D005260:Female; D019569:Hemifacial Spasm / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins