Abstract
<strong>Background:</strong> The aim was to elucidate clinical trial efficacy, safety, and dosing practices of abobotulinumtoxinA (ABO) treatment in adult patients with blepharospasm and hemifacial spasm. To date, most literature reviews for blepharospasm and hemifacial spasm have examined the effectiveness of all botulinum neurotoxin type A products as a class. However, differences in dosing units and recommended schemes provide a clear rationale for reviewing each product separately. <strong>Methods:</strong> A systematic literature review was performed to identify randomized controlled trials and other comparative clinical studies of ABO in the treatment of blepharospasm and hemifacial spasm published in English between January 1991 and March 2015. Medical literature databases (PubMed, Cochrane library, EMBASE) were searched. A total of five primary publications that evaluated ABO for the management of blepharospasm and hemifacial spasm were identified and summarized. <strong>Results:</strong> Data included 374 subjects with blepharospasm and 172 subjects with hemifacial spasm treated with ABO. Total ABO doses ranged between 80 and 340 U for blepharospasm and 25 and 85 U for hemifacial spasm, depending on the severity of the clinical condition. All studies showed statistically significant benefits for the treatment of blepharospasm and hemifacial spasm. ABO was generally well tolerated across the individual studies. Adverse events considered to be associated with ABO treatment included: ptosis, tearing, blurred vision, double vision, dry eyes, and facial weakness. <strong>Discussion:</strong> These data from 5 randomized clinical studies represents the available evidence base of ABO in blepharospasm and hemifacial spasm. Future studies in this area will add to this evidence base.
Highlights
Blepharospasm and hemifacial spasm are disabling movement disorders involving the facial muscles that are routinely treated with botulinum neurotoxin type A (BoNT-A).Blepharospasm is a focal dystonia characterized by excessive involuntary blinking or forceful closure of the eyelids
The main aim of this systematic review is to summarize the relevant data on efficacy and safety profile of ABO in blepharospasm and Hemifacial spasm (HFS)
The studies generally showed that clinical improvements were seen within a week of injection and that the therapeutic effect lasted at least 3 months
Summary
Blepharospasm and hemifacial spasm are disabling movement disorders involving the facial muscles that are routinely treated with botulinum neurotoxin type A (BoNT-A).Blepharospasm is a focal dystonia characterized by excessive involuntary blinking or forceful closure of the eyelids. Botulinum Toxin in Blepharospasm and Hemifacial Spasm closure of the eyelids can be caused by failure of voluntary levator contraction, a condition known as “apraxia of lid opening”; the two conditions may co-exist.[2] Patients with mild blepharospasm can present with eyestrain and a sensation of dryness in the eyes that contributes to excessive blinking. These symptoms are sometimes difficult for physicians to distinguish from tic disorders, though tics involving the face are more likely to be suppressible for brief periods and generally do not improve with the use of a “sensory trick.”. Future studies in this area will add to this evidence base
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