Treatment of aberrant facial nerve regeneration with botulinum toxin A.
OBJECTIVE
To assess the effect and efficacy of botulinum toxin type A (BTX-A) at reducing and maintaining eyelid synkinesia in aberrant facial nerve regeneration, while concurrently observing for the presence of side effects to differing treatment doses.


METHODS
A prospective interventional study of five patients with eyelid synkinesia resulting from aberrant regeneration of the facial nerve. Patients were treated with injections of either 120, 80 or 40 units of BTX-A (Dysport) into the orbicularis oculi. Objective and subjective reduction in synkinesia, maintenance of response and presence of side effects were recorded.


RESULTS
All five patients had improvement of the synkinesia with BTX-A treatment. Lower doses were found to be as effective as higher doses. Mean duration of abolished synkinesia was three months. Two patients developed a ptosis which resolved spontaneously. None of the patients treated with the lowest dose of 40 units developed a ptosis.


CONCLUSIONS
Low-dose BTX-A has a lower incidence of ptosis and is effective in the treatment of aberrant facial nerve regeneration.
Chua
C N
CN
Oxford Eye Hospital Radcliffe Infirmary, Oxford, UK. chuaoxford@hotmail.com
Quhill
F
F
Jones
E
E
Voon
L W
LW
Ahad
M
M
Rowson
N
N
D000328:Adult; D000368:Aged; D001764:Blepharospasm / Q000188:drug therapy* / Q000209:etiology; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005152:Facial Muscles / Q000294:innervation; D005154:Facial Nerve / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008297:Male; D009416:Nerve Regeneration; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D046608:Synkinesis / Q000188:drug therapy* / Q000209:etiology
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A