[Treatment of blepharospasm and facial hemispasm with botulinum toxin. Apropos of 58 injections in 22 patients].

Through this analysis we shall report our experience about botulinum toxin in view of relieving blepharospasm and hemifacial spasm. Many Treatments have been tested with very inconstant often deceptive and sometimes even dangerous results. The present method gives us the possibility to paralyze the spasmed muscles by direct injection into the muscle. After 58 ambulatory injections, 53 effective results were obtained with complete spasm relief for a mean internal of 4 to 5 months. No systemic effect was noticed, but some transient ophthalmic incidents occurred: they can be avoided by simple technical precautions. In hemifacial spasm, the orbicularis eyelid muscle seems to be the "spasm starter" and its unique injection by toxin can often relieve the whole hemiface. This simple method appears remarkably effective, although its duration is limited to a few months; but the injections can be conveniently repeated. However, this technique has to be carefully performed by experienced physicians. It is extremely regrettable to see the enormous price increase of toxin within the last years. This limits a larger use for patients good health.