title: Clinical features and treatment status of hemifacial spasm in China.
abstract: BACKGROUND
  Hemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.
  
  
  METHODS
  A cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.
  
  
  RESULTS
  In this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.
  
  
  CONCLUSIONS
  The onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310020, China.
authors.forename: Xingyue
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Hongjuan
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai 20003, China.
authors.forename: Wenzhao
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Neurology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
authors.forename: Lingjing
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of Neurology, Xi'an Central Hospital, Xi'an, Shaanxi 710003, China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
authors.forename: Weixi
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
authors.forename: Yajun
authors.initials: Y
authors.lastname: Lian
authors.affiliation: Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China.
authors.forename: Zhanhua
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Huifang
authors.initials: H
authors.lastname: Shang
authors.affiliation: Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong 250021, China.
authors.forename: Yabo
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Neurology, Nanjing Brain Hospital affiliated to Nanjing Medical Hospital, Nanjing, Jiangsu 210029, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China.
authors.forename: Weifeng
authors.initials: W
authors.lastname: Luo
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. Email: dr.wanxh@gmail.com.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Wan
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D019569:Hemifacial Spasm / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A