title: Long-term therapy of benign essential blepharospasm and facial hemispasm with botulinum toxin A: retrospective assessment of the clinical and quality of life impact in patients treated for more than 15 years.
abstract: Botulinum toxin type A (BoNT-A) is recognized as the treatment of choice for patients with blepharospasm and facial hemispasm. We report the results of long-term BoNT-A therapy (15-20 years) in a group of patients with blepharospasm (9 patients) and hemifacial spasm (18 patients). We evaluated the number of treatment sessions, duration of therapeutic effects, side effects and their frequency during long-term therapy, and the differences between these two groups of patients. We used patient self-assessment and a patient questionnaire to evaluate the influence of the treatment on their quality of life. We have concluded that BoNT-A is an effective and safe long-term treatment of these facial dyskinesias. Despite the different pathophysiology of blepharospasm and facial hemispasm, the therapy effectiveness is comparable. The only differences were in the side effects. In patients with blepharospasm, the side effect frequency was higher and manifested by double vision or eyelid ptosis. In patients with facial hemispasm, the most frequent side effect was lower facial weakness. No association between therapy duration and side effect frequency was determined. Based on patient questionnaires, all patients believed that the treatment was safe and effective with a positive impact on their quality of life, especially in social communication.
authors.affiliation: First Department of Neurology, Medical Faculty, St. Anne's Hospital, Masaryk University, Pekařská 53, 656 91, Brno, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Streitová
authors.forename: Martin
authors.initials: M
authors.lastname: Bareš
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001764:Blepharospasm / Q000188:drug therapy* / Q000523:psychology*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005158:Facial Paralysis / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A