Premium
Long‐term efficacy and safety of botulinum toxin A injections to treat blepharospasm and hemifacial spasm
Author(s) -
Ababneh Osama H,
Cetinkaya Altug,
Kulwin Dwight R
Publication year - 2014
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12165
Subject(s) - medicine , blepharospasm , hemifacial spasm , botulinum toxin , adverse effect , ptosis , anesthesia , retrospective cohort study , surgery , botulism , facial nerve , biology , genetics
Background To evaluate efficacy and safety of botulinum toxin A injections after more than 10 consecutive years of treatment for benign essential blepharospasm and hemifacial spasm. Design Retrospective chart review at university‐affiliated hospital. Participants Study consisted of 64 patients treated with botulinum toxin A injections between O ctober 2005 and M ay 2006. Methods Inclusion criteria included patients treated with at least one annual botulinum toxin‐ A injection for more than 10 consecutive years. Data collected included diagnoses and patient characteristics, injection dates, doses administered at each visit, response scores, duration of effect, and adverse events. Main Outcome Measures Included changes in doses, response scores, duration of effects, and adverse events between the first and last botulinum toxin A injections. Results Thirty‐two of 64 patients (mean age at first injection, 57.2 ± 12.4 years; 25 women) met the inclusion criteria. The mean duration of follow up was 14.1 ± 3.1 years (range 10–20 years; mean total visits 44.4 ± 19). A higher mean injection dose per visit was administered during the last year compared with the first year (26.8 ± 10.3 vs. 22.5 ± 7.5 units, respectively) ( P = 0.003). The mean durations of effect during the first and last years were 12.4 ± 7.1 and 14.6 ± 7.0 weeks, respectively ( P = 0.076). There were no significant differences between genders or between benign essential blepharospasm and hemifacial spasm subgroups. The most common adverse events were ptosis, lagophthalmos and dry eye. Conclusions Botulinum toxin A is an effective, safe, long‐term treatment for patients with benign essential blepharospasm and hemifacial spasm. Sustained treatment efficacy required higher doses; however, fewer adverse reactions developed.