Multicentric comparative study of botulinum toxin treatment in patients with hemifacial spasm.

Abstract

Introduction: Hemifacial spasm (HFS) is a neurological disorder characterized by involuntary contractions of the facial muscles. Botulinum toxin (BTX-A) is an effective treatment, but its efficacy may vary across different geographical contexts. This multicentric study aims to compare the efficacy of BTX-A in treating HFS between centers in Morocco and France.

Methods: A retrospective study was conducted with 128 patients diagnosed with HFS, distributed between one center in Morocco and two centers in France. Parameters studied included age, sex, average treatment duration, dose administered, injection sites, injection frequency, and adverse effects. The results were analyzed separately for primary and secondary HFS. An HSF-8 score was used to evaluate treatment outcomes, assessing patients before treatment and two months after receiving BTX-A injections.

Results: This multicentric study assessed the efficacy of botulinum toxin (BTX-A) for treating hemifacial spasm (HFS) in centers in France and Morocco. Among the 128 patients included, 75% were women, with a mean age of 61.5 years. On average, patients had been receiving BTX-A injections for 6.49 ± 5.4 years, experiencing a mean self-reported improvement of 94.7% ± 2.3%. The treatment effect lasted approximately 3.15 ± 1.2 months per injection. Notable differences were observed between France and Morocco regarding the average dose per injection and injection frequency. Side effects were observed in 39.84% of patients in France compared to 10.94% in Morocco, but there was no significant difference. The most frequently reported side effects included ptosis, diplopia, and dry eyes. These effects are generally temporary and did not require discontinuation of treatment. The efficacy of BTX-A was objectively measured using the HFS-8 score, with significant improvements observed in both countries. Despite variations in therapeutic approaches, the overall efficacy of BTX-A remained comparable between the two countries, indicating consistent therapeutic outcomes across geographical contexts.

Conclusion: This multicentric study confirms the efficacy of botulinum toxin (BTX-A) in the treatment of HFS, with significant improvements and a well-tolerated side effect profile. While differences exist in treatment practices between Morocco and France, the overall efficacy of the treatment remains comparable, underscoring the reliability of BTX-A as an effective therapy across different geographical contexts.