Effect of cold compression before botulinum neuro- toxin injection in hemifacial spasm

Abstract

Objectives: To compare the effect of using cold compression before injecting botulinum toxin (BTX) versus not using cold compression, on pain and bleeding at the injection site, efficacy and the quality of life of patients with hemifacial spasm (HFS). Methods: A prospective, randomized, case crossover design was employed. One hundred fifty-nine (159) patients who were diagnosed as having primary HFS with BTX treatment in the botulinum toxin clinic were randomized during the period from May 2017 to November 2017. Patients were divided into two groups – with cold compression and without cold compression before BTX injection and then evaluated for the severity and frequency of HSF using the Jankovic Rating Scale and quality of life questionnaire. Immediate complications after injection such as pain and bleeding were also assessed. Results: Cold compression before BTX injection significantly decreased the severity and frequency of HFS (p<0.001). Pain in cases where cold compression was used before BTX injection was significantly lower than in those cases not receiving cold compression (p<0.001). Satisfaction scores and bleeding were significantly different (p<0.001). Quality of life was significantly improved after treatment with BTX (p<0.001). Conclusion: Cold compression before BTX injection can improve the efficacy of treatment by reducing severity and frequency. This study confirms previous studies that using cold compression before BTX injection results in a good outcome in relation to satisfaction and bleeding. No significant complications were found. Additionally, BTX injection can also improve quality of life in hemifacial spasm patients.