LOCAL INJECTIONS OF BOTULINUM TOXIN-A IN SPASMODIC TORTICOLLIS, BLEPHAROSPASM, AND HEMIFACIAL SPASM - SIDE-EFFECTS AND RISKS

The presynaptically denervating effect of botulinum toxin A is used fo r the treatment of spasmodic torticollis, blepharospasm, and hemifacia lspasm. The present results have proven the injections as a safe and e fficacious modality for the treatment of blepharospasm and hemifacial spasm. In blepharospasm BOTOX may be offered as a primary form of ther apy. The most frequent side effects are periorbital swelling, ptosis a nd lagophthalmos. In about 80% of patients with spasmodic torticollis the injections result in substantial benefit. Side effects (above all dysphagia and neck weakness) are reversible and tolerable. Formation o f antibodies against the toxin may develop, which limits its long-term use. Clinical experience with the toxin has not been sufficiently lon g to facilitate assessment of possible long-term side effects.