[What to do in cases of inadequate effectiveness of botulinum toxin for the treatment of eyelid cramping?].

In 5-15% of individuals suffering essential blepharospasm, treatment with botulinum toxin is insufficient. In these cases the following measures can be applied: increase the dose, increase or vary the injection sites, change the botulinum toxin medication, use additional oral medication, or perform surgery. Certain measures can also be carried out by the patient. In cases of hemifacial spasm, inadequate results of botulinum toxin injections are even more unusual. But for these cases, additional oral medication or the neurosurgical Janetta operation can be used.