Treatment of Blepharospasm and Oromandibular Dystonia with Botulinum Toxins

Toxins (Basel). 2020 Apr 22;12(4):269. doi: 10.3390/toxins12040269.


Blepharospasm and oromandibular dystonia are focal dystonias characterized by involuntary and often patterned, repetitive muscle contractions. There is a long history of medical and surgical therapies, with the current first-line therapy, botulinum neurotoxin (BoNT), becoming standard of care in 1989. This comprehensive review utilized MEDLINE and PubMed and provides an overview of the history of these focal dystonias, BoNT, and the use of toxin to treat them. We present the levels of clinical evidence for each toxin for both, focal dystonias and offer guidance for muscle and site selection as well as dosing.

Keywords: AbobotulinumtoxinA; DaxibotulinumtoxinA; IncobotulinumtoxinA; Meige syndrome; OnabotulinumtoxinA; RimabotulinumtoxinB; blepharospasm; botulinum toxin; oromandibular dystonia.

Publication types

  • Review

MeSH terms

  • Blepharospasm / drug therapy*
  • Blepharospasm / epidemiology
  • Botulinum Toxins / therapeutic use*
  • Dystonic Disorders / drug therapy*
  • Dystonic Disorders / epidemiology
  • Humans
  • Mandibular Diseases / drug therapy*
  • Mandibular Diseases / epidemiology
  • Muscular Diseases / drug therapy*
  • Muscular Diseases / epidemiology
  • Neuromuscular Agents / therapeutic use*


  • Neuromuscular Agents
  • Botulinum Toxins