Use of botulinum A toxin (BOTOX) in different types of facial dystonia.

UNLABELLED: This study was carried out in the Eye Departments of Combined Military Hospital, Kharian and Military Hospital, Rawalpindi, from January 2007 to August 2008. To determine the effects of botulinum A toxin (Botox) injection in different types of facial dystonia. A total of 23 botulinum A toxin (Botox) injections were given in 13 patients including 7 males and 6 females. Patients were followed up at 1 week, 6 weeks and 6 months after the injection. The indications were essential blepharospasm in 4 (30.77 %) cases and hemifacial spasms in 9 (69.23%) cases. Age ranged from 28 to 60 years (mean 41 +/- 12 years). Four patients were given injections three times and 2 patients were injected twice. Onset of action of botulinum A toxin (Botox) was variable, starting on the same day in 3 patients while in the rest of patients it started on the next day. Mean duration of action was 12.77 weeks +/- 4.68 (range 6-23 weeks). Dystonia improved in all the cases. Temporary slight facial paresis and lagophthalmos occurred in 3 (23%) cases while ptosis occurred in 2 (15.4%) cases. Two patients (15%) had mild ocular irritation and conjunctival congestion after injection, which settled with topical mild steroid (fluorometholone).
CONCLUSION: Botulinum A toxin (Botox) is useful treatment for different types of facial dystonia.