P-MD014. Long term repeated use of botulinum toxin injection for hemifacial spasms in sri lanka

Abstract

Introduction. Hemifacial spasm is a common indication for botulinum toxin use. Aim of this study was to find out the efficacy and safety of long-term use of botulinum toxin for hemifacial spasms in Sri Lanka. Methods. A group of 28 patients with hemifacial spasms who had been given botulinum toxin for more than 7 years were included in the study. Botulinum toxin was given at multiple sites including over the eyelid, at the ipsilateral orbicularis oculi, nasalis, orbicularis oris, mentalis and contralateral orbicularis oris sites on a dilution of 2 ml/100 units. Patients were then followed up every 3 months. Degree of improvement, side effects if any, the total number of units used and the information regarding the last injection used were collected. Results. There were 24 females with a female preponderance of 86%. Mean age (SD) at first injection of the patients was 58.7 (9.1) years. Mean (SD) duration of the repeated use was 10.5 (2.2) years. Range of the duration of treatment was from 7 to 15 years. During this duration, mean (SD) number of injections given was 25.2 (8). Average number of units given for each patient during these multiple injections was 20.3 (2.6). Improvement was seen in 96.5% of the times and side effects were seen only in 2.7% of the time and included heaviness of the eye, mild lower facial weakness and pain at the site of injection which did not last long. Patient compliance was good even after repeated long term use. There were no systemic side effects and drug resistance to botulinum toxin was not seen in these patients. Conclusion. These findings show that the long-term use of botulinum toxin for more than 10 years seems to be safe and efficacious for hemifacial spasm.