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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(01): s00441793935
DOI: 10.1055/s-0044-1793935
Original Article

Dosage of botulinum toxin in patients undergoing treatment for hemifacial spasm: is there modification during follow-up?

Fátima de Menezes Dantas 
1   Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Natal RN, Brazil.
,
Felipe Olobardi Freire 
1   Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Natal RN, Brazil.
,
Agábio Diógenes Pessoa Neto 
2   Instituto de Ensino e Pesquisa Alberto Santos Dumont, Ambulatório Multiprofissional de Doença de Parkinson, Macaíba RN, Brazil.
,
Clécio de Oliveira Godeiro Júnior 
3   Universidade Federal do Rio Grande do Norte, Hospital Universitário Onofre Lopes, Serviço de Neurologia, Natal RN, Brazil.
,
Rodrigo Alencar e Silva 
3   Universidade Federal do Rio Grande do Norte, Hospital Universitário Onofre Lopes, Serviço de Neurologia, Natal RN, Brazil.
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Abstract

Background The movement disorder known as hemifacial spasm is characterized by involuntary contractions of the muscles that are innervated by the facial nerve. The treatment of choice for this condition is botulinum toxin injections.

Objective To analyze the botulinum toxin dosage in patients undergoing treatment for hemifacial spasm during a 14-year period.

Methods A retrospective study of medical records from patients treated at the Neurology Service of Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, from 2010 to 2024, was performed.

Results A total of 151 patients met the inclusion criteria. The dose of botulinum toxin revealed a statistically significant increase during the first 3.46 years of follow-up. In the long-term, a trend toward dose stabilization was identified. The median latency for the onset of effect was 4 days, while the median duration of effect was 3 months. All side effects were temporary, with the most common being hemifacial weakness (17.9%) and palpebral ptosis (3.3%). Most patients presented primary hemifacial spasm (88.1%), with a neurovascular conflict identified in 24.1% of cases.

Conclusion The increase in botulinum toxin dosage during the first years may be explained by dosage adjustment to control hemifacial spasm with the lowest possible doses. A prolonged interval between applications may also be associated with this increase. Dose stabilization tends to be achieved over time, indicating disease control.

Keywords

Hemifacial Spasm - Botulinum Toxins - Botulinum Toxins, Type A

Authors' Contributions

FMD: data curation, writing – original draft, writing– review & editing, and formal analysis; FOF: data curation, writing – original draft, writing– review & editing, and visualization; ADPN: data curation and writing – review & editing; COGJ: conceptualization, writing – original draft, writing – review & editing, and supervision; and RAS: conceptualization, writing – original draft, writing – review & editing, financial support, supervision, and data curation.


Support

The present study was supported financially by one of its authors (RAS).


Editor-in-Chief: Hélio A. G. Teive.


Associate Editor: José Luiz Pedroso.




Publikationsverlauf

Eingereicht: 29. Mai 2024

Angenommen: 15. September 2024

Artikel online veröffentlicht:
15. Januar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Fátima de Menezes Dantas, Felipe Olobardi Freire, Agábio Diógenes Pessoa Neto, Clécio de Oliveira Godeiro Júnior, Rodrigo Alencar e Silva. Dosage of botulinum toxin in patients undergoing treatment for hemifacial spasm: is there modification during follow-up?. Arq Neuropsiquiatr 2025; 83: s00441793935.
DOI: 10.1055/s-0044-1793935