Abstract
Objective: To describe selected clinical characteristics and evaluate the treatment outcomes of abobotulinumtoxinA (Dysport®) therapy in patients with primary hemifacial spasm at the Neurology Center, Bach Mai Hospital. Methods: This longitudinal observational study, combining retrospective and prospective data collection, included 60 patients with primary hemifacial spasm treated with botulinum toxin A. Spasm severity was assessed using the Jankovic Rating Scale before injection and at 2 weeks, 1 month, and 3 months after injection. Quality of life was evaluated using the HFS-7 questionnaire before and after treatment, and overall treatment outcomes were classified according to the Soulayrol scale. Changes in Jankovic scores were analyzed using the Friedman test followed by Wilcoxon signed-rank tests for pairwise comparisons. HFS-7 scores before and after treatment were compared using the Wilcoxon signed-rank test. Associations between categorical variables were assessed using Fisher’s exact test. Results: Women accounted for 66.7% of the study population, and the mean age was 55.13 ± 8.58 years. Symptoms began in the orbicularis oculi muscle in 78.3% of patients, and right-sided hemifacial spasm accounted for 53.3% of cases. The mean baseline Jankovic score was 2.75 ± 0.73. The mean Dysport dose was 83.28 ± 17.32 U, ranging from 52 to 115 U; the 60–100 U dose group was the most common, accounting for 63.3% of patients. No statistically significant associations were observed between Dysport dose and either treatment effectiveness or adverse effects (p > 0.05). The mean time to initial clinical response was 4.27 ± 3.02 days, the maximum therapeutic effect was reached after 3.12 ± 2.42 weeks, and the mean duration of effect was 4.35 ± 1.33 months. The mean Jankovic score decreased to 0.93 ± 0.55 at 2 weeks, 0.85 ± 0.63 at 1 month, and 1.73 ± 0.78 at 3 months after injection (Friedman test, p < 0.001). The mean HFS-7 score decreased from 13.48 ± 4.88 before treatment to 6.03 ± 4.21 after treatment (p < 0.001). The overall treatment effectiveness rate was 95.0%, with good outcomes observed in 83.3% of patients. At least one adverse effect was reported in 35.0% of patients, with ptosis being the most common adverse effect (25.0%). No statistically significant associations were found between age, disease duration, or baseline spasm severity and treatment effectiveness (p > 0.05). Conclusion: Botulinum toxin A therapy markedly improved spasm severity and quality of life in patients with primary hemifacial spasm. The therapeutic effect appeared relatively early, lasted for an average of more than four months, and the reported adverse effects were predominantly localized.
