Results of Long-term Therapy of Essential Blepharospasm and Facial Hemispasmwith Botulotoxin A

Overview

Botulotoxin A (BT) was administered to 51 patients (40 patients with essentialblepharospasm, 11 patients with facial hemispasm) 299 times since December 1993till January 2002. Total doses of 20 – 48 U of the preparation BOTOX (AllerganInc.) were administered bilaterally in essential blepharospasm, doses of 12 – 24U were administered unilaterally in facial hemispasm. The mean duration oftherapeutic effect evaluated by the patient was 12.2 weeks (3-28 weeks) in theblepharospasm group and 13.8 weeks (7-35 weeks) in the hemispasm group. Nogeneral side effects were noted. Local complications in the blepharospasm groupwere observed in 8.83% (ptosis in 5.62 %) and those in the facial hemispasm in8.16 % (ptosis in 2.04 %) from the total number of BT administration in therespective groups. The therapeutic effect during the long-term administrationwas decreasing andrequired increasing doses ofBTbymore than 10%, as observedin 9 patients with essential blepharospasm (22.5 %). The mean increase of BT doserequired to maintain sufficient therapeutic effect was by 32 % (14-66 %). Twopatientswiththe longest 8-yearperiod ofobservationhavenotrequiredincreasingdosages above 16 U unilaterally over the last 5 years. The treatment with BT-Aexerted the same effects in most cases even during long-term therapy lastingseveral years. The need to increase the doses of the administered BT was morefrequent during the first two years of the treatment. Locally administered botulotoxinA is a safe and efficient remedy for the therapy of essential blepharospasmandfacialhemispasm,theefficiency beingunchangedinmorethan80%ofpatients.

Key words:
botulotoxin, blepharospasm, hemispasm, therapy