Assessment of quality of life in patients with cervical dystonia and hemifacial spasm after botulinum toxin injections.

Background: Botulinum toxin is now used to treat a variety of neurological and non-neurological disorders. Despite the fact that injections of botulinum neurotoxin may significantly reduce the involuntary muscular contractions associated with focal dystonia and hemifacial spasm (HFS), it is less certain whether the motor effect would result in an improvement in health-related quality of life (HR-QoL).Our goal was to evaluate how botulinum toxin affected individuals with cervical dystonia and hemifacial spasm in terms of their quality of life, self-esteem, pain, sleep, and depression.

Methods: This is a prospective study that included 40 patients diagnosed with cervical dystonia or hemifacial spasm treated with Botulinum toxin. Quality of life, self-esteem, pain, sleep and depression were all assessed in the studied patients by self-reporting questionnaires to assess the impact of botulinum toxin on them.

Results: The quality of life with its components (physical, physical role, emotional role, vitality, mental health, social functioning and pain) showed significant improvement at the end of follow up compared to baseline with p values ≤ 0.001. Also, there was a significant improvement of self-esteem score, depression score, at the end of follow up period compared to baseline assessment with p value 0.012, < 0.001 respectively. Moreover, there was a significant improvement of all pain scales and sleep quality scores with p values < 0.05 except the habitual sleep efficiency.

Conclusion: botulinum toxin is an effective therapy for motor and non-motor manifestations associated with focal cervical dystonia and hemifacial spasm as well as the quality of life and to conclude that its effectiveness is dependent not only on the elimination of physical symptoms, but also on improving the patients' and their families' emotional and social status to help providing the drug to all eligible patients.