From April 1983 to April 1988, 381
botulinum toxin injections for lid
spasms were administered to 106 patients. Sixty-nine had bilateral
blepharospasm and 37 had
hemifacial spasm. Of the 381
injections, 308 had been given to patients who returned for follow-up examinations. No systemic effects were noted at any of these visits; all side effects were temporary; there were no serious complications. Ptosis, the most frequently encountered problem, occurred after 26 (8.4%) of the
injections. Other complications included: corneal exposure (after eight
injections, 2.59%); face droop (after 11
injections, 3.57%);
diplopia (after five
injections, 1.62%); and subtle visual blurring (after eight
injections, 2.59%). One patient noted jaw tenseness, another mentioned tearing, one reported brow droop, and another complained of crossed eyes. Ten
injections had minimal effect; in these cases a repeat injection usually was effective. Only four patients chose surgery after beginning
injections. We conclude that
botulinum toxin injections are a safe, effective means of treating lid
spasms.