Abstract
Hemifacial spasm is nearly always a unilateral disease of the facial musculature and is characterized by involuntary tonic or clonic cramps that considerably reduce the affected patient's quality of life. In the past, a number of different conservative and operative therapeutic procedures have been applied for the treatment of hemifacial spasm. In many cases these attempts failed to control the disease permanently or resulted in unwanted, sometimes strong, side effects. We report our own experiences with botulinum therapy in 29 patients with hemifacial spasm (78 therapeutic sessions). In our patients the mean duration of an effect after treatment with botulinum toxin was 18.2 weeks. Side effects were rare. Our results since 1990 at the University of Göttingen demonstrate that subcutaneous application of toxin from Clostridium botulinum to involved facial muscles represents a reliable method for successful treatment of hemifacial spasm.
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References
Alexander GE, Moses H (1982) Carbamazepine for hemifacial spasm. Neurology 32:286–287
Ceballos-Baumann AO, Gasser T, Dengler R, Oertel WH (1990) Lokale Injektionsbehandlung mit Botulinum-Toxin A bei Blepharospasmus, Meige-Syndrom und Spasmus hemifacialis. Nervenarzt 61:604–610
Dengler R, Konstanzer A, Ceballos-Baumann AO (1990) Lokale Therapie mit Botulinum Toxin A bei fokalen Dystonien. Akt Neurol 17:133–138
Digre K, Corbett JJ (1988) Hemifacial spasm: differential diagnosis, mechanism, and treatment. Adv Neurol 49:151–176
Dressler D, Benecke R, Conrad B (1989) Botulinum Toxin in der Therapie kraniozervikaler Dystonien. Nervenarzt 60:386–393
Dutton JJ, Buckley EG (1986) Botulinum toxin in the management of blepharospasm. Arch Neurol 43:380–382
Ehni G, Woltman HW (1945) Hemifacial spasm. Arch Neurol Psychiatr 53:205–211
Elston JS (1986) Botulinum toxin treatment of hemifacial spasm. J Neurol Neurosurg Psychiatry 49:827–829
Greenwood J (1946) The surgical treatment of hemifacial spasm. J Neurosurg 3:506–510
Iwakuma T, Matsumoto A, Nakamura N (1982) Hemifacial spasm. Comparison of three different operative procedures in 110 patients. J Neurosurg 57:753–756
Jankovic J, Orman J (1987) Botulinum A toxin for cranial-cervical dystonia: a double-blind, placebo-controlled study. Neurology 37:616–623
Jannetta PJ (1970) Microsurgical exploration and decompression of the facial nerve in hemifacial spasm. Curr Top Surg Res 2:217–220
Jannetta PJ, Abbasy M, Maroon JC, Ramos FM, Albin MS (1977) Etiology and definitive microsurgical treatment of hemifacial spasm. J Neurosurg 47:321–328
Jones TW, Waller RR, Samples JR (1985) Myectomy for essential blepharospasm. Mayo Clin Proc 60:663–666
Laskawi R, Stennert E, Limberg C (1990) Eletrophysiological investigations in patients with hemifacial spasm. In: Castro D (ed) Facial nerve. Kugler & Ghedini, Amsterdam, pp 465–467
Mauriello HA (1985) Blepharospasm, Meige Syndrome and hemifacial spasm: treatment with botulinum toxin. Neurology 35:1499–1500
Patrinely JR, Whiting AS, Anderson RL (1988) Local side effects of botulinum toxin injections. Adv Neurol 49:493–500
Piatt JH, Wilkins RH (1984) Treatment of tic doloreux and hemifacial spasm by posterior fossa exploration: therapeutic implications of various neurovascular relationships. Neurosurgery 14:462–471
Poewe W, Kleedorfer B (1989) Therapie des essentiellen Blepharospasmus und hemifacialen Spasmus mit lokalen Injektionen von Botulinum-Toxin A: Erfahrungen an 50 Patienten. Akt Neurol 16:78–82
Savino PJ, Sergott RL (1985) Hemifacial spasm treated with botulinum A toxin injection. Arch Ophthalmol 103:1305–1306
Schnyder H, Meyer M (1992) Die Behandlung des Spasmus hemifacialis mit Botulinum-Toxin. Schweiz Rundschau Med (PRAXIS) 25:819–823
Scott AB (1981) Botulinum toxin injection of eye muscles to correct strabismus. Trans Am Ophthalmol Soc 89:734–770
Tolosa E, Marti MJ, Kulisevsky J (1988) Botulinum toxin injection therapy for hemifacial spasm. Adv Neurol 49:479–491
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Laskawi, R., Ellies, M., Drobik, C. et al. Botulinum toxin treatment in patients with hemifacial spasm. Eur Arch Otorhinolaryngol 251, 271–274 (1994). https://doi.org/10.1007/BF00181883
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DOI: https://doi.org/10.1007/BF00181883