Efficacy of isolated periocular botulinum toxin A injections versus periocular and adjunctive lower facial injections in hemifacial spasm: a randomized, controlled, noninferiority, crossover trial.

ABSTRACT:

Purpose

To evaluate the necessity of botulinum toxin A (BoNT-A) administration in the lower face of patients with hemifacial spasm (HFS).

Methods

A randomized controlled non-inferiority crossover trial was conducted with 46 HFS patients (non-inferiority margin = 1). Patients were randomized (1:1) to receive either isolated periocular BoNT-A injections followed by conventional injections (periocular and lower face area) or the reverse sequence, with a 16-week washout. Primary outcomes were visual analog scale (VAS) for periocular and lower face regions at 4 weeks post injection. Secondary outcomes included the Hemifacial Spasm Grading Scale (HSGS), Samsung Medical Center grading system (SMC), HFS questionnaire (HFS-30), and adverse events. Trial registration: TCTR20220916002.

SUBMITTER: Eiamsamarng A 

PROVIDER: S-EPMC12302396 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature