Clinical Findings Of Hemifacial Spasm And Treatment Of Botulinum Toxin

Objective:To describe the clinical findings of hemifacial spasm and the current treatment options for hemifacial spasm, especially patients’response to the treatment of botulinum toxin.Methods:52hemifacial spasm patients attending at the botulinum clinic of Sir Run Run Shaw Hospital took part in the questionnaire research, which is aimed to evaluate the clinical findings of hemifacial spasm and treatment responses to the botulinum toxin. Another group of77healthy people was evaluated by the similar questionnaire, in order to compare the difference between the two groups in lifestyle and mood.Results:The average age of the control group is51.81±10.22(range29-77),sex ratio(M:F)19:33, average age of onset is44.72±11.10(range25-74), average duration7.49±4.73(range1-20).The control group consist of77healthy people, average age49.22±7.09(range30-68),sex ratio(M:F)37:40.94%of the patients had their onset in orbitularis orbis. Orbitularis orbis, levator labii superioris, levator anguli oris and zygomaticus are the most commonly affected muscles. Visual disturbance, social interference and facial discomfort are the most commonly complaints from hemifacial spasm patients. There’re no significant differences between two groups in age, sex ratio or lifestyle, but the case group scored much higher in the assessment of depression and anxiety than the control group. The average latency after the injection of botulinum toxin in the case group is5.95±5.22(95%CI:4.37-7.54) days, and the average duration of the treatment14.84±4.30(95%CI13.53-16.15) weeks. The mean response rating after the injection is3.40±0.54(95%CI:3.23-3.56)Conclusion:Hemifacial spasm is a peripherally induced movement disorder characterized by involuntary, unilateral, intermittent, irregular, tonic or clonic contractions of muscles innervated by the ipsilateral facial nerve. Patients with hemifacial spasm usually present at their40and50years of age. The orbicularis orbis is the most common site of the initial involvement followed by other regions innervated by the ipsilateral facial nerve. Social embarrassment, visual disturbance and facial discomfort are the most common complaints. Patients seem to become depressive or anxious easily comparing to the control group, and stress, anxiety can exacerbate the symptom. Injection of botulinum toxin is the choice of the treatment, which can relief the symptoms remarkably. Long-term use of botulinum toxin is proved to be effective and safe.