Preseptal and Pretarsal Botulinum Toxin Injection in Hemifacial Spasm and Blepharospasm: A 10-year Comparative Study (P11-11.007)

Abstract

<h3>Objective:</h3> To determine the efficacy, safety, and cost between PS and PT injection in HFS and BEB. <h3>Background:</h3> Preseptal (PS) and pretarsal (PT) botulinum toxin injections are approved for hemifacial spasm (HFS) and blepharospasm (BEB). However, the long-term data is limited. <h3>Design/Methods:</h3> The data were retrieved between 2011 and 2021. Consecutive HFS and BEB botulinum toxin patients were categorized as PS and PT. Study outcomes were the difference in pre-and post-treatment modified Jankovic scale, self-reporting scales, time-related treatment, safety, and cost. <h3>Results:</h3> Of 152 botulinum toxin-injected patients, 117 (77.0%) patients had HFS and 35 (33.0%) patients had BEB. 1,665 injections in HFS (920 PS and 745 PT) and 527 injections in BEB (210 PS and 317 PT) were analyzed. The difference between pre-and post-treatment mJS was lower in the PS group than in the PT group in both HFS and BEB (1.5±0.8 vs. 1.8±0.6, P-value &lt;0.001 and 1.8±0.8 vs. 3.1±0.9, P-value &lt;0.001). Self-reporting scales in HFS did not differ between the two groups, while BEB with the PS group reported lower scores than PT. Latency to response in HFS with PS appeared longer than PT, whereas it became shorter compared BEB with PS to PT. Duration of maximum response in HFS was not different between groups, while the BEB with PS had a longer duration than BEB with HFS . The PS injection carried overall adverse events than the PT (9.4% vs. 5.2%, P-value &lt;0.001). The total dose and cost per session in PS group is lower in both PS and PT for onabotulinum toxin whereas significantly higher for abobotulinum toxin. <h3>Conclusions:</h3> PT injections lessened symptom severity with fewer side effects. Further studies on the pharmacoeconomics of both techniques are required. <b>Disclosure:</b> Dr. Teekaput has nothing to disclose. Dr. Thiankhaw has nothing to disclose.