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บทคัดย่อ

Background: To study about factors that associated with duration of response of botulinum toxin in hemifacial spasm and to expect time of re- injection of botulinum toxin, for the purpose of highest efficiency

Method: Hemifacial spasm patients in hemifacial spasm clinic that were injected with botulinum toxin in Ratchaburi Hospital from January 2013 to August 2013 were prospectively selected. Clinical features and basic data were recorded. Outcome after injection was evaluated.

Results: 22 cases were enrolled in this study. (male 4, female 18), mean ages 60.23 years, duration before treatment : 1 month - 15 years, right side 10, left side 12, severity: of spasm eye closure less than 50% = 14, eye closure 50 - 90 % = 7, eyes closure 100% = 1

     All cases had improvement : improvement less than 50% = 5 (22.7%) more than 50% = 17 (77.3%)

     Frequency of spasm : less than 25% of day time = 10 (45.5%), 25-50% of day time = 12 (54.5%)

     Duration of response : 60 - 80 days = 9 (40.9%), more than 80 days = 13 (59.1%)

     All cases had satisfaction and satisfy more than 60% = 18 (81.8%)

     Major side effects were low level of angular of mouth (27.3%) and ptosis (22.7%), side effect were less severe and spontaneous recovery .

     Severity of spasm associated reversely with response time (p = .01).

     Cases that eye closure less than 50% had response time at 86.6 days.

     Cases that eye closure 50 - 90% had response time at 77.1 days.

     Case that eye closure 100% had response time at 75 days.

Conclusion: Severity of spasm is the important factor in expect time of response. This conclusion should be used to detect follow up time and then collect proper cases with proper quantity of drug for highest efficiency especially in the new open clinic.