To determine the long-term efficacy of
botulinum toxin injections for the treatment of facial
dyskinesias we studied 50 consecutive patients with
blepharospasm,
hemifacial spasm, and
Meige syndrome. All received their first injection between September 1983 and June 1984. A total of 520
injections were given; the average number of
injections per patient was 10.4 over the seven-year period ending September 1990. Twenty-six (52%) of the patients continued to return for periodic
injections, while three patients no longer receive
injections since they failed to respond adequately to treatment. Three patients with
blepharospasm were in remission and required no further treatment, after a series of six, four, and three
injections. Six patients were treated until they died of causes unrelated to facial
dyskinesia or its treatment. Six patients are still being treated elsewhere because they could obtain
injections closer to their homes. Five of the original 50 patients have been lost to follow-up. A patient with
hemifacial spasm had one injection with good result but was not sufficiently bothered by
her disease to return for reinjection. Complications were transient, minimal, well tolerated, and did not increase with increased number of
injections.