Effects of delay in botulinum toxin treatment on patients with hyperkinetic facial disorders

Abstract

Aim: Hyperkinetic facial disorders include Benign Essential Blepharospasm (BEB) and Hemifacial Spasm (HFS), which involve involuntary facial muscle contractions. Botulinum toxin (BTX) is essential for relieving symptoms. The Coronavirus-19 (COVID-19) pandemic-related restrictions have led to delays in receiving BTX treatment. This study aims to assess the impact of BTX treatment delays in patients with hyperkinetic facial disorders.

Materials and Methods: This study retrospectively examined the data of 84 patients (68 HFS and 16 BEB) whose BTX appointments were delayed due to COVID-19 restrictions. Patient status was evaluated using Jankovic disability rating scale (JRS) scores, and administered BTX doses were documented and compared before and after lockdown.

Results: After the BTX treatment delay, the median JRS scores significantly increased from 2 before the lockdown to 3 after the lockdown (p<0.001). Furthermore, there was a noticeable increase in the average BTX treatment dose after the lockdown, from 35 units to 37.5 units (p<0.001).

Conclusion: Longer intervals between injections may increase disease severity and the effective BTX  doses in patients with HFS and BEB. The COVID-19 pandemic has highlighted the importance of timely BTX therapy in managing hyperkinetic facial disorders.