| Abstract | Botulinum A toxin has been reported to provide excellent symptomatic relief for patients with dystonia. To analyse the treatment, complications, and outcome of patients receiving botulinum A toxin injection, the case records 170 patients attending the Botox Clinic at the Kwong Wah Hospital from 1 December 1992 to 31 December 1996 were reviewed. Of these 170 patients, 130(76.5%) had idiopathic hemifacial spasm, 18(10.6%) had blepharospasm, 18(10.6%) had spasmodic torticollis, and 4(2.4%) had generalised or focal limb dystonia. One hundred and sixty-six(97.6%) patients were Chinese. The average dose of botulinum A toxin required for an optimal response was 14.54U for those with hemifacial spasm, 49.64U for those blepharospasm, and 137U for those with spasmodic torticollis. Among patients with hemifacial spasm, 103(81.7%) gave a good response, 21(16.7%) gave a partial response, and there was no response in two(1.6%)patients. The corresponding figures for patients with blepharospasm were 7(38.9%), 10(55.6%), and 1(5.6%), respectively; for those with spasmodic torticollis, the figures were 6(37.5%), 6(37.5%), and 4(25%), respectively. Complications from botulinum A toxin injection were rare(less than 10%), minor, transient, and usually dose-related. In conclusion, idiopathic hemifacial spasm was the most common type of movement disorder encountered in our Botox Clinic and botulinum A toxin injection was safe and effective in the majority of patients. |
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