Efficacy of botulinum toxin A for treatment of unilateral spasms of the eyelid and its prognosis.

BACKGROUND To this date, only a small number of studies have described the long-term use of BTX in Hemifacial spasm. AIM To assess the prognosis and long-term effectiveness of Botulinum toxin A (BTXA) in the treatment of unilateral spasms of the eyelid. PATIENTS AND METHODS From September 1998 to January 2006, 245 consecutive cases of unilateral spasms of the eyelid were included in this retrospective study. Among them, 143 patients (BTXA group) underwent BTXA injection treatment, and 102 patients did not receive any intervention (control group). BTXA injections were made subcutaneously around the eye with the dose of 2.5U other than the temporal canthus of 5U. Follow-up was performed for 1-7 years after the last injection. RESULTS In BTXA treatment group, the complete remission rate was 78.3% (112/143), recurrence rate was 21.7% (31/143) and the incidence of hemifacial spasm (HFS) was 18.9% (27/143); complete remission rate for patients with disease duration less than 3 months was 96.6% (86/89); for patients with a 3-6 months disease history, complete remission rate was 75.8% (25/33), and patients having the disease course exceeding 6 months had a complete remission rate of 4.8% (1/21). In the control group, the complete remission rate was 12.7% (13/102), and the prevalence of HFS was 71.6% (73/102); 16.7% (9/56) of patients with the disease duration less than 3 months were remitted, but the complete remission rate was 12.9% (4/31) for patients with a 3-6 months disease history. None was in remission when the disease history exceeded 6 months. CONCLUSIONS BTXA treatment can improve the complete remission rate and prevent further progression of unilateral spasms of the eyelid into HFS, especially in early stage.