Abstract

GUIMARAES, Joana; ROSAS, Maria José  and  SIMOES, Fernanda. Efficacy of botulinum toxin in the treatment of craniofacial and hemifacial spasm over a 14-year period . Arq Med [online]. 2007, vol.21, n.2, pp.55-58. ISSN 2183-2447.

Introduction: Botulinum toxin (BTX) is an effective therapy for a wide variety of muscle hyperactivity states and focal dystonias. Since was officially licensed, BTX has gained widespread acceptance as a safe and effective treatment. Objective: We reviewed the clinical characteristics and long-term outcome of our outpatient dystonia clinic that made BTX since 1989. Methods: We analyse treatment related aspects (onset of benefit, Duration of action, efficacy, side effects) of 276 patients with craniofacial and hemifacial spasm treated with BTX since January 1989 to January 2003. Results: Treatment efficacy was 85,9% in blepharospasm; 95,6% in hemifacial spasm and 87% in cervical dystonia. Sustained benefit was similar after 14 years. Although 13,4% of patients reported adverse effects at any time during the course of treatment, this represents a small percentage of all treatment cycles. The highest frequency of side effects occurred in patients with HF. None of the patients discontinued therapy due intolerable adverse effects. Conclusion: Reviewing the literature and according to our series we conclude that BTX A is an effective treatment. It is safe for long-term treatment of cranio-facial dystonia and hemifacial spasm. Adverse effects are transient and minor, mostly related with dosage and experience of the doctors.

Keywords : botulinum toxin; hemifacial spasm; blepharospasm; cervical dystonia.

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