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Botulinum Toxin Injection in Hemifacial Spasm

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Hemifacial Spasm

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Abstract

Even though hemifacial spasm is not a life-threatening disorder, it could be disabling for patients and affect their quality of life. Therefore, symptomatic management of spasm as well as curative treatment is important. Among symptomatic treatment options, botulinum toxin injection therapy is safe and effective treatment for hemifacial spasm. Considering the goal of botulinum toxin injection is symptomatic control of spasm, there are essential steps to get the maximal benefit and minimal side effects from botulinum toxin. Physicians should set up their protocol for injection (routine protocol), and discuss expected results (for both effects and side effects) with patients. Additionally, it is important to recognize target muscles and target dose for each muscle based on the facial muscle anatomy and the involvement of spasm. In this chapter, we will review all these steps for botulinum toxin injection therapy, based on the previous literature and our experiences at Samsung Medical Center. The basic mechanism and pharmacologic characteristics of botulinum toxin will be not discussed in this chapter but in the next chapter (“Medical treatment of hemifacial spasm and other involuntary facial movement disorders”).

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References

  1. Wang A, Jankovic J. Hemifacial spasm: clinical findings and treatment. Muscle Nerve. 1998;21:1740–7.

    Article  CAS  Google Scholar 

  2. Lee JA, Jo KW, Kong DS, Park K. Using the new clinical grading scale for quantification of the severity of hemifacial spasm: correlations with a quality of life scale. Stereotact Funct Neurosurg. 2012;90:16–9.

    Article  Google Scholar 

  3. Reimer J, Gilg K, Karow A, Esser J, Franke GH. Health-related quality of life in blepharospasm or hemifacial spasm. Acta Neurol Scand. 2005;111:64–70.

    Article  CAS  Google Scholar 

  4. Tan EK, Seah A. Health-related quality of life in blepharospasm and hemifacial spasm. Arch Ophthalmol. 2007;125:1141.

    Article  Google Scholar 

  5. Heuser K, Kerty E, Eide PK, Cvancarova M, Dietrichs E. Microvascular decompression for hemifacial spasm: postoperative neurologic follow-up and evaluation of life quality. Eur J Neurol. 2007;14:335–40.

    Article  CAS  Google Scholar 

  6. Lee JA, Kim KH, Park K. Natural history of untreated hemifacial spasm: a study of 104 consecutive patients over 5 years. Stereotact Funct Neurosurg. 2017;95:21–5.

    Article  Google Scholar 

  7. Mauriello JA Jr, Leone T, Dhillon S, Pakeman B, Mostafavi R, Yepez MC. Treatment choices of 119 patients with hemifacial spasm over 11 years. Clin Neurol Neurosurg. 1996;98:213–6.

    Article  Google Scholar 

  8. Na BS, Cho JW, Park K, et al. Severe hemifacial spasm is a predictor of severe indentation and facial palsy after microdecompression surgery. J Clin Neurol. 2018;14:303–9.

    Article  Google Scholar 

  9. Scott AB. Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. J Pediatr Ophthalmol Strabismus. 1980;17:21–5.

    Article  CAS  Google Scholar 

  10. Scott AB, Rosenbaum A, Collins CC. Pharmacologic weakening of extraocular muscles. Investig Ophthalmol. 1973;12:924–7.

    CAS  Google Scholar 

  11. Jost WH, Kohl A. Botulinum toxin: evidence-based medicine criteria in blepharospasm and hemifacial spasm. J Neurol. 2001;248(Suppl 1):21–4.

    Article  CAS  Google Scholar 

  12. Flanders M, Chin D, Boghen D. Botulinum toxin: preferred treatment for hemifacial spasm. Eur Neurol. 1993;33:316–9.

    Article  CAS  Google Scholar 

  13. Batisti JP, Kleinfelder AD, Galli NB, Moro A, Munhoz RP, Teive HA. Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated. Arq Neuropsiquiatr. 2017;75:87–91.

    Article  Google Scholar 

  14. Park YC, Lim JK, Lee DK, Yi SD. Botulinum a toxin treatment of hemifacial spasm and blepharospasm. J Korean Med Sci. 1993;8:334–40.

    Article  CAS  Google Scholar 

  15. Yoshimura DM, Aminoff MJ, Tami TA, Scott AB. Treatment of hemifacial spasm with botulinum toxin. Muscle Nerve. 1992;15:1045–9.

    Article  CAS  Google Scholar 

  16. Simpson DM, Blitzer A, Brashear A, et al. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70:1699–706.

    Article  CAS  Google Scholar 

  17. Hallett M, Albanese A, Dressler D, et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of movement disorders. Toxicon. 2013;67:94–114.

    Article  CAS  Google Scholar 

  18. Jitpimolmard S, Tiamkao S, Laopaiboon M. Long term results of botulinum toxin type A (Dysport) in the treatment of hemifacial spasm: a report of 175 cases. J Neurol Neurosurg Psychiatry. 1998;64:751–7.

    Article  CAS  Google Scholar 

  19. Lee JA, Kim KH, Kong DS, Lee S, Park SK, Park K. Algorithm to predict the outcome of microvascular decompression for hemifacial spasm: a data-mining analysis using a decision tree. World Neurosurg. 2019;125:e797–806.

    Article  Google Scholar 

  20. Youn J, Kwon S, Kim JS, Jeong H, Park K, Cho JW. Safety and effectiveness of microvascular decompression for the treatment of hemifacial spasm in the elderly. Eur Neurol. 2013;70:165–71.

    Article  Google Scholar 

  21. Elston JS. Botulinum toxin treatment of hemifacial spasm. J Neurol Neurosurg Psychiatry. 1986;49:827–9.

    Article  CAS  Google Scholar 

  22. Defazio G, Abbruzzese G, Girlanda P, et al. Botulinum toxin A treatment for primary hemifacial spasm: a 10-year multicenter study. Arch Neurol. 2002;59:418–20.

    Article  Google Scholar 

  23. Costa J, Espirito-Santo C, Borges A, et al. Botulinum toxin type A therapy for hemifacial spasm. Cochrane Database Syst Rev. 2005;2005:CD004899.

    PubMed Central  Google Scholar 

  24. Linder JS, Edmonson BC, Laquis SJ, Drewry RD Jr, Fleming JC. Skin cooling before periocular botulinum toxin A injection. Ophthalmic Plast Reconstr Surg. 2002;18:441–2.

    Article  Google Scholar 

  25. Soylev MF, Kocak N, Kuvaki B, Ozkan SB, Kir E. Anesthesia with EMLA cream for botulinum A toxin injection into eyelids. Ophthalmologica. 2002;216:355–8.

    Article  Google Scholar 

  26. Cakmur R, Ozturk V, Uzunel F, Donmez B, Idiman F. Comparison of preseptal and pretarsal injections of botulinum toxin in the treatment of blepharospasm and hemifacial spasm. J Neurol. 2002;249:64–8.

    Article  CAS  Google Scholar 

  27. Lolekha P, Choolam A, Kulkantrakorn K. A comparative crossover study on the treatment of hemifacial spasm and blepharospasm: preseptal and pretarsal botulinum toxin injection techniques. Neurol Sci. 2017;38:2031–6.

    Article  Google Scholar 

  28. Brin MF, Fahn S, Moskowitz C, et al. Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. Mov Disord. 1987;2:237–54.

    Article  CAS  Google Scholar 

  29. Boghen DR, Lesser RL. Blepharospasm and Hemifacial Spasm. Curr Treat Options Neurol. 2000;2:393–400.

    Article  CAS  Google Scholar 

  30. Frei K, Truong DD, Dressler D. Botulinum toxin therapy of hemifacial spasm: comparing different therapeutic preparations. Eur J Neurol. 2006;13(Suppl 1):30–5.

    Article  Google Scholar 

  31. Jankovic J, Schwartz K, Donovan DT. Botulinum toxin treatment of cranial-cervical dystonia, spasmodic dysphonia, other focal dystonias and hemifacial spasm. J Neurol Neurosurg Psychiatry. 1990;53:633–9.

    Article  CAS  Google Scholar 

  32. Elston JS. The management of blepharospasm and hemifacial spasm. J Neurol. 1992;239:5–8.

    Article  CAS  Google Scholar 

  33. Van den Bergh P. Botulinum toxin treatment in clinical neurology. Acta Neurol Belg. 1995;95:70–9.

    PubMed  Google Scholar 

  34. Yu YL, Fong KY, Chang CM. Treatment of idiopathic hemifacial spasm with botulinum toxin. Acta Neurol Scand. 1992;85:55–7.

    Article  CAS  Google Scholar 

  35. Tousi B, Perumal JS, Ahuja K, Ahmed A, Subramanian T. Effects of botulinum toxin-B (BTX-B) injections for hemifacial spasm. Parkinsonism Relat Disord. 2004;10:455–6.

    Article  Google Scholar 

  36. Wan XH, Vuong KD, Jankovic J. Clinical application of botulinum toxin type B in movement disorders and autonomic symptoms. Chin Med Sci J. 2005;20:44–7.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jinyoung Youn

  2. Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea

    Jinyoung Youn

  3. Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea

    Wooyoung Jang

  4. Department of Neurology, Cheonan Soonchunhyang Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea

    Jong Kyu Park

Authors
  1. Jinyoung Youn
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  2. Wooyoung Jang
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  3. Jong Kyu Park
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Correspondence to Jinyoung Youn .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea (Republic of)

    Kwan Park

  2. Department of Neurosurgery, Konkuk University School of Medicine Chungju Hospital, Chungju, Korea (Republic of)

    Jae Sung Park

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Youn, J., Jang, W., Park, J.K. (2020). Botulinum Toxin Injection in Hemifacial Spasm. In: Park, K., Park, J.S. (eds) Hemifacial Spasm. Springer, Singapore. https://doi.org/10.1007/978-981-15-5417-9_13

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