ABSTRACT
To determine the effectiveness of Botulinum toxin in the treatment of Benign Essential Blepharospasm [BEB] and Hemifacial spasm [NFS] at a tertiary care hospital. Neurology Department, Bolan Medical Complex Hospital, Quetta. 30 months from 15 March 2010 to August 2012. Quasi experimental study. All patients referred to neurophysiology laboratory for Botox [BTX] injection were enrolled in the study after taking written consent. Botox injection 1.25 units was used for BEB and 3.0 units used for HFS given in the laboratory. Patients were observed for any immediate complications and then followed at two weeks for start of improvement and side effects and then at one, three and six months for duration of lasting improvement and any side effects. In this hospital based study we enrolled 30 patients with the diagnosis of BEB and HFS. The average age of the patients was 52.47 +/- 11.59. Out of 30 patients 57% were male and 43% were female with 1.3:1 male to female ratio. Blepharospasm was observed in 53.3% patients and hemifacial spasm was observed in 46.7% patients. In 50% of patients the onset of improvement was within 4-7 days. 93.4% of patients had improvement at the end of one month and 80% patients had improvement at 3 months follow up. Total duration of benefit lasted for up to 4-5 months in 46.6% of patients, 30% patients had benefit lasting for more than 5 months. 16.7% patients noticed benefit for up to 3 months and only 6.7% patients had benefit of only 2 months. Side effects such as Ptosis, diplopia, photophobia, redness of eyes, dry eyes and facial weakness occurred in 23% of patients in first week and up to one month while only 6.7% patients continued to have side effects at 3 months. This is the first study of its kind in our local population. This study concludes that the BTX is highly effective in the management of BEB and HFS and it is well tolerated