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The following is a summary of “Efficacy and safety of botulinum neurotoxin in the treatment of hemifacial spasms: a systematic review and meta-analysis,” published in the October 2024 issue of Neurology by Wang et al.

Hemifacial spasm (HFS), a neuromuscular condition causing unilateral facial muscle spasms, adversely impacts patients’ QoL due to its social implications. Botulinum neurotoxin (BoNT) injections offer a therapeutic option for managing this condition.

Researchers conducted a retrospective study to assess the efficacy and safety of BoNT injections in patients with HFS.

They conducted a systematic review and meta-analysis of studies on BoNT injections for HFS published from January 1, 2000, to May 1, 2024. The study quality was assessed with the Cochrane and Joanna Briggs Institute (JBI) tools, managed data using EndNote X9, and performed statistical analysis via Review Manager (RevMan 5.4) and STATA 14.0.

The results showed that 35 studies, 2 RCTs with 83 patients, compared perioral BoNT injections to placebo, while 33 single-arm studies assessed outcomes in 2,786 patients post-BoNT injection. The pooled estimate demonstrated high effectiveness in 17 studies analyzing effectiveness rates (Effect Size: 0.882, 95% CI: 0.830, 0.926, P<0.001). Depression scores (Standardized Mean Difference (SMD): -0.85, 95% CI: -1.34, -0.35, P<0.001), anxiety scores (SMD: -1.50, 95% CI: -2.19, -0.80, P<0.001), and overall QoL scores (SMD: -0.64, 95% CI: -0.87, -0.41, P=0.766) improved significantly with BoNT. Ptosis was the most frequent AE (OR: 0.30, 95% CI: 0.11, 0.81, P=0.843).

They concluded that BoNT injections were effective and safe for HFS, particularly in alleviating depression.

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03883-x