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Blepharospasm & Hemifacial Spasm

Treatment with Botulinum Toxin
Botulinum toxin is a neurotoxin protein which is used in tiny amounts to cause temporary controlled paralysis of muscles. It acts by preventing the nerve from releasing its trigger messenger chemicals (neurotransmitter) which tells the muscle to move. There are varous brands of botulinum toxin which have been licensed for the treatment of blepharospasm/ hemifacial spasm including Botox, Dysport and Xeomin. Regardless of brand of Botulinum Toxin, all treatments are given by injecting tiny doses of the medicine into affected muscles.

How long does Botulinum Toxin work for?
The effect of each treatment is two to three months and so a regular treatment programme will be required.

Does it help everybody?
Botulinum toxin is very effective in the vast majority of patients with blepharospasm and hemifacial spasm. However in a small proportion of patients, botulinum toxin injections are not effective e.g. due to side effects, allergies. For botulinum toxin injections to work, the patients needs to realise that accurate dosage of the medicine and repeated regular injections are necessary. It therefore takes some time to slowly establish the exact dosage, where to inject and how often to inject before the patient gets any benefit.

Side effects of Botulinum Toxin
It is crucial to obtain the correct dosage and be accurate and consistent in injection pattern. Side effects occur due to unwanted paralysis of neighbouring muscles causing drooping eyelids (ptosis), double vision. In the vast majority of patients this is very temporary and most patients tolerate these unwanted effects very well.


Surgery for Blepharospasm and Hemifacial Spasm
In a tiny minority of patients in whom botulinum toxin injections are not tolerated, surgery may be necessary.