ABSTRACT
The long-term efficacy of Botulinun Toxin in the treatment of focal dystonias, hemifacial spasm and spasticity was assessed in all patients treated at King Khalid University Hospital between February 1991 and December 1998. A satisfactory response was initially obtained and later on sustained in the majority of patients with hemifacial and blepharospasm [91%], spasmodic torticollis [75%] and spasticity [61%]. In writer's cramp favourable response was restricted to a smaller group [22%], however this effect was sustained in most responders. Most patients with hemidystonia or generalized dystonia showed poor response inspite of using high doses. Peak responses were noted 4-5 weeks after treatment and the beneficial effect lasted for a mean of 14 weeks. In general, this benefit was persistent with repeated injections over 1.5-7 years of follow-up, with apparent tendency for total dose as well as side effects reduction. Local side effects were mild and short-lived, while systemic side effects were not observed. Botulinum toxin is a safe medication of considerable persistent benefits in treating hemifacial spasm, blepharospasm, spasmodic torticollis, certain group of writer's cramp and spasticity. Other potential indications for BTX-A use are reviewed