Factors associated with quality of life in hemifacial spasm and blepharospasm during long-term treatment with botulinum toxin

This study was undertaken to assess the impact of hemifacial spasm (HFS) and blepharospasm (BS) on quality of life (QOL) during
long-term treatment with botulinum toxin injections.

Fifty-three patients with HFS and 32 patients with BS as well as two healthy age- and sex-matched control groups were included
in the study. All participants independently completed the disease-specific questionnaire for QOL, the HFS-30, and the Thai
Depression Inventory, and also provided a peak improvement score assessment.

The disease severity in both patient groups revealed mild functional impairment. The scores of HFS-30 in HFS patients (four
of 8 subscales) and BS patients (3 of 8 subscales) were significantly higher than the control groups. In both HFS and BS,
depression scores were positively correlated with the HFS-30 scores, while peak improvement and educational level were inversely
correlated with the HFS-30 scores. Patients with BS were more affected in Mobility and Activities of Daily Living than HFS
patients.

Both HFS and BS affect QOL both physically and mentally despite clinical improvement with botulinum toxin. Depression and
peak improvement after injection were associated with the level of QOL.