Keywords:
hemifacial spasm, botulinum toxin, short-term prognosis
Abstract
Background & Objectives: Hemifacial spasm (HFS) is a chronic disease characterized by unilateral tonic and clonic contractions of the facial muscles innervated by the facial nerve. The persistent attacks can significantly impact patients’ daily lives. The most efficacious therapy has been reported to be botulinum toxin (BTX). This study aims to investigate the factors that affect the short-term prognosis of HFS patients treated with BTX type A therapy, as well as to determine the clinic-demographic profile of such patients.
Methods: This is a retrospective cohort study of patients with HFS who were treated with BTX at the Movement Disorders Clinic of Makati Medical Center (MMC). The HFS Score was used to assess the severity and frequency of the eye and cheek spasms, and the degree of suffering in health-related quality of life (HRQOL) parameters.
Results: Sixty-four participants were included in the study. The patients’ characteristics were the following: mean age of 50.18 years; female predominance; most without comorbidities; mean disease duration of 7.83 years; eye as the most common location of initial spasm (96.88%); disease progression of 22.85 months; majority were previously treated with BTX (79.69%); and mean interval of 10.96 months from last BTX session. Regression analysis revealed that there were factors which influenced the short-term prognosis after treatment: (1) history of prior BTX therapy was associated with better clinical parameters, while (1) history of prior BTX therapy, (2) disease duration, and (3) location of initial spasm were associated with improvement of specific HRQOL parameters.
Conclusion: BTX therapy has been established as efficacious in improving the clinical, functional and psychosocial aspects of HFS patients. The factors which influenced the botulinum response were different compared to other papers, highlighting potential differences in predictor variables across populations.
Author Biographies
Dr. Paulo Cataniag, Makati Medical Center
Dr. Paulo Cataniag is currently a first year Movement Fellow at the Makati Medical Center, with simultaneous training in clinical and research aspects of movement disorders. Aside from managing patients at the Movement Disorders Clinic, he is also actively teaching the interns and residents of the hospital through bedside rounds and lectures. He has delivered lectures in many community outreach activities for patients with Parkinson’s disease, Hemifacial spasm and X-linked Dystonia Parkinsonism, with upcoming talks to patients with Spinocerebellar Ataxia and Tourette’s syndrome. With regards to research, Dr. Cataniag has recently participated in a collaborative research with the University of Lubeck regarding XDP. He has ongoing research projects involving XDP, Parkinson’s disease, Hemifacial Spasm, DBS, PSP and other topics. His case series abstract of two XDP patients who underwent pallidotomy was published in the journal Movement Disorders and was presented as a poster during the recent MDS International Congress in Philadelphia, USA.
Dr. Jed Noel Ong, Makati Medical Center
Dr. Jed Noel Ong is an Adult Neurologist at the Makati Medical Center and Chinese General Hospital and Medical Center with the subspecialty in Parkinson’s Disease and Movement Disorders. He is currently the Training Officer of the Movement Disorders Fellowship of Makati Medical Center. Dr. Ong has been active in the field of Movement Disorders in the Philippines as he is the current Treasurer of the Movement Disorder Society of the Philippines, a member of the Movement Disorders Council of the Philippine Neurological Association and the head of the Movement Disorders Database of the Philippine Neurological Association. He is also the current representative of the Philippines for Asian Oceanian Association of Neurology Young Members Group and is part of the organizing committee of the upcoming lecture series in Movement Disorders. He is likewise an active member of the International Parkinson’s Disease and Movement Disorders Society and is part of the MDS Movement Disorders in Asia Study Group. He is also part of the faculty of San Beda University College of Medicine and teaches Neuroscience and Neuroanatomy. His research interests are on different movement disorders particularly on Parkinson’s Disease, Atypical Parkinsonism and X-Linked Dystonia Parkinsonism. He is part of the ongoing collaborative studies on X-Linked Dystonia Parkinsonism between with Makati Medical Center and University of Lübeck in Germany.
Dr. Cid Czarina Diesta, Makati Medical Center
Dr. Cid Czarina Diesta is a Neurology consultant at the Makati Medical Center and Asian Hospital and Medical Center with subspecialty in Movement Disorder and heads the Movement Disorder Center of the Makati Medical Center and the Asian Hospital and Medical center. She teaches on special topics at the following medical schools: San Beda College of Medicine, Ateneo College of Medicine and Lyceum College of Medicine. She has lectureships on different topics of Neurology and Movement Disorders. Dr. Diesta has been active in the Movement Disorder Society of the Philippines. She previously served as vice president and currently a member of the organization. Her research interests are on different movement Disorders such as X linked dystonia parkinsonism (XDP), Parkinson’s disease, Spinocerebellar ataxia, Hemifacial spasms and DRPLA . She has ongoing collaborative researches with University of Lubeck in Germany and Massachusettes General Hospital, in Boston on X-linked dystonia Parkinsonism. Her interests has led to recent significant publications on X-linked Dystonia Parkinsonism as follows: Basal Ganglia Atrophy as a Marker for Prodromal X-linked Dystonia-Parkinsonism, Elucidating Hexanucleotide Repeat Number and Methylation within the X-Linked Dystonia-Parkinsonism (XDP)-Related SVA Retrotransposon in TAF1 with Nanopore Sequencing.
