Use of botulinum A toxin (BOTOX) in different types of facial dystonia.

Abstract

This study was carried out in the Eye Departments of Combined Military Hospital, Kharian and Military Hospital, Rawalpindi, from January 2007 to August 2008. To determine the effects of botulinum A toxin (Botox) injection in different types of facial dystonia. A total of 23 botulinum A toxin (Botox) injections were given in 13 patients including 7 males and 6 females. Patients were followed up at 1 week, 6 weeks and 6 months after the injection. The indications were essential blepharospasm in 4 (30.77 %) cases and hemifacial spasms in 9 (69.23%) cases. Age ranged from 28 to 60 years (mean 41 +/- 12 years). Four patients were given injections three times and 2 patients were injected twice. Onset of action of botulinum A toxin (Botox) was variable, starting on the same day in 3 patients while in the rest of patients it started on the next day. Mean duration of action was 12.77 weeks +/- 4.68 (range 6-23 weeks). Dystonia improved in all the cases. Temporary slight facial paresis and lagophthalmos occurred in 3 (23%) cases while ptosis occurred in 2 (15.4%) cases. Two patients (15%) had mild ocular irritation and conjunctival congestion after injection, which settled with topical mild steroid (fluorometholone). Botulinum A toxin (Botox) is useful treatment for different types of facial dystonia.