title: Treatment outcome correlates with knowledge of disease in hemifacial spasm.
abstract: OBJECTIVE
  Hemifacial spasm (HFS), a potentially disabling facial condition affects quality of life (QOL) and botulinum toxin is an effective treatment. No studies have examined whether a better level of knowledge of the disease would lead to an improved quality of life and treatment response in HFS. We examined the relationship between knowledge of disease with improvement in QOL following botulinum toxin treatment in HFS patients.
  
  
  METHODS
  A total of 106 HFS patients (mean age of 56.8+/-9.9 years) were prospectively included. A baseline knowledge questionnaire and a validated disease-specific quality of life scale (HFS-7) were administered before and after botulinum toxin treatment.
  
  
  RESULTS
  A better educational level was an independent predictor of high knowledge of HFS (p=0.02). Multivariate analysis using improvement in HFS-7 (total and subscore) as outcomes, and adjusting for age, gender, education, severity and duration of HFS, showed that high knowledge was predictive of a bigger improvement in HFS-7 total (p=0.03) and HFS-7 subscore (p=0.03).
  
  
  CONCLUSIONS
  HFS patients with high knowledge of disease reported better improvement in QOL following botulinum toxin treatment. Better educational efforts will augment current medical and surgical treatments in improving QOL in HFS. Our findings could potentially be extended to many other medical conditions.
authors.affiliation: Department of Neurology, Singapore General Hospital, National Neuroscience Institute, Duke-NUS Graduate Medical School, Singapore. gnrtek@sgh.com.sg
authors.forename: Eng-King
authors.initials: EK
authors.lastname: Tan
authors.forename: Shahul
authors.initials: S
authors.lastname: Hameed
authors.forename: S
authors.initials: S
authors.lastname: Fook-Chong
authors.forename: Khadijah
authors.initials: K
authors.lastname: Hussein
authors.forename: Sau-Ying
authors.initials: SY
authors.lastname: Lum
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D005260:Female; D019569:Hemifacial Spasm / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins