Quantitative change in botulinum toxin a treatment over time in patient with eential blepharopam and idiopathic hemifacial pam

Purpoe To evaluate the quantitative change in botulinum toxin A (BTA) treatment required over time to achieve relief for 3 to 4 month in patient with eential blepharopam (EB) and idiopathic hemifacial pam (IHF). Deign Interventional cae erie. Method In thi retropective longitudinal tudy in an intitutional ophthalmologic outpatient clinic, data were retrieved from patient file and a comparion between patient with EB and IHF wa performed. The patient population conited of 27 patient, 17 with EB and 10 with IHF, who were treated for the firt time with BTA injection and were followed up for 4 to 6 conecutive year. All patient initially received 12 or more coure of treatment with a lower doe (≤20 U) and were then witched to a higher doe (>20 U). The main outcome meaure were the hift in the doe-repone relationhip between the lower and higher doe and were analyzed with repect to four variable: average number of treatment, doage, duration of therapy, and interval of ymptomatic relief. Reult In the EB group the mean doe for each patient changed from 16.0 ± 1.4 U (lower doe) to 24.2 ± 1.4 U (higher doe). The hift occurred after a mean of 8.8 ± 2.9 treatment per patient given for a mean of 33.5 ± 13.3 month. The mean interval of relief wa longer with the lower doe than with the higher doe (4.0 ± 1.4 month v 3.2 ± 1.0 month, repectively). In the IHF group, the mean doe / patient changed from 16.8 ± 1.2 U to 25.0 ± 1.8 U, and the witch occurred after a mean of 6.5 ± 2.3 treatment given over a mean period of 23.8 ± 6.6 month. The mean duration of treatment with the lower doe wa horter than with the higher doe. The interval of relief wa imilar for both doe range (3.8 ± 10 month and 4.1 ± 1.3 month, repectively). The IHF group witched to the higher doe earlier, by both number and duration of treatment, than the EB group. Only minor and tranient ide effect of treatment were oberved in both group. Concluion Botulinum toxin A i an effective and afe treatment for EB and IHF. The doe in our tudy wa increaed over time by 50% to achieve 3 to 4 month of ymptomatic relief with minimal complication.