Quality of Life in Hemifacial Spasm Patient after Treatment with Botulinum Toxin A; A 24-week, Double-Blind, Randomized, Cross-over Comparison of Dysport®®®®® and Neuronox®®®®® Study
Subsai Kongsengdao MD*, Saksit Kritalukkul MD**
Affiliation : * Division of Neurology, Department of Medicine, Rajvithi Hospital, Department of Medical Services, Public Health Ministry, Bangkok, Thailand ** Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background : Hemifacial spasm (HFS) is a common movement disorder, presented with unilateral, intermittent, irregular,
tonic or clonic contraction of facial expression muscles without any identifiable etiology. Comparison of quality of life (QoL)
between Dysport® and Neuronox® has not been studied in HFS patients.
Objective : To evaluate the QoL after treatment with botulinum toxin A (Dysport® and Neuronox®) injection in HFS patient.
Material and Method: A 24-week, double-blind, randomized, cross-over comparison of QoL in HFS patients after being
treated with botulinum toxin A (Dysport®) and botulinum toxin A (Neuronox®) was performed. Assessment of QoL composed
of hemifacial spasm-30 (HFS-30), medical outcome study short form 36 items (SF-36), abnormal involuntary movement
scale (AIMS) and center for epidemiologic studies-depression (CES-D) questionnaire, were performed at week 0, week 12,
and week 24. The 24-hour HFS diary, recorded for 4 weeks after treatment was also evaluated.
Results : Total of 26 HFS patients were enrolled between May 2010 and January 2011. The mean HFS-30, AIMS and CES-D
were reduced after treatment without any difference between the two groups. The mean SF-36 was not changed in both groups.
However, mean HFS-30 (p = 0.09), AIMS (p = 0.02) and CES-D (p < 0.001) of all treated patients were reduced across the
treatment period. Total intensity score of HFS, duration of facial muscles spasm per day and duration of functional impairment
per day in Dysport® group were significantly lower than the Neuronox® group (p < 0.001).
Conclusion : There was no difference between Dysport® and Neuronox® in the aspect of QoL in HFS patients. However, there
was improvement of QoL after multiple botulinum toxin A injection.
Keywords : Hemifacial spasm, Botulinum toxin A Dysport® Neuronux®, Quadity of Life
