Botulinum toxin in the treatment of facial dyskinesias

Ann Acad Med Singap. 1991 Mar;20(2):223-7.


Patients with hemifacial spasm (N = 25), blepharospasm (n = 8), and benign eyelid fasciculation (n = 2) were treated with botulinum toxin injections (PHLS, Porton Down, England). All patients reported substantial symptomatic relief. Marked improvement was seen in fifteen patients with hemifacial spasm and six patients with blepharospasm. Benign eyelid fasciculation was completely abolished. Beneficial effects was evident two to three days after injections, became maximum at one week, and remained effective for up to six months. Side effects were transitory and mild. They included periorbital edema, mild diplopia, ptosis and facial weakness. Only in two patients was ptosis unacceptable. Severity of side effects was dose-related. Reinjections had similar efficacy. Botulinum toxin therapy is a safe and effective treatment for these facial dyskinesias and should be considered a viable alternative to surgical procedures.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Blepharospasm / drug therapy*
  • Blepharospasm / physiopathology
  • Botulinum Toxins / administration & dosage
  • Botulinum Toxins / adverse effects
  • Botulinum Toxins / therapeutic use*
  • Eyelid Diseases / drug therapy*
  • Eyelid Diseases / physiopathology
  • Facial Muscles*
  • Fasciculation / drug therapy*
  • Fasciculation / physiopathology
  • Female
  • Humans
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Spasm / drug therapy*
  • Spasm / physiopathology
  • Videotape Recording


  • Botulinum Toxins