Botulinum toxin type A (
BoNT-A) is recognized as the treatment of choice for patients with
blepharospasm and facial hemispasm. We report the results of long-term
BoNT-A therapy (15-20 years) in a group of patients with
blepharospasm (9 patients) and
hemifacial spasm (18 patients). We evaluated the number of treatment sessions, duration of
therapeutic effects, side effects and their frequency during long-term
therapy, and the differences between these two groups of patients. We used patient self-assessment and a patient questionnaire to evaluate the influence of the treatment on their quality of life. We have concluded that
BoNT-A is an effective and safe long-term treatment of these facial
dyskinesias. Despite the different pathophysiology of
blepharospasm and facial hemispasm, the
therapy effectiveness is comparable. The only differences were in the side effects. In patients with
blepharospasm, the side effect frequency was higher and manifested by
double vision or
eyelid ptosis. In patients with facial hemispasm, the most frequent side effect was lower facial weakness. No association between
therapy duration and side effect frequency was determined. Based on patient questionnaires, all patients believed that the treatment was safe and effective with a positive impact on their quality of life, especially in social communication.