Outcome predictors, efficacy and safety of Botox and Dysport in the long-term treatment of hemifacial spasm

A. R. Bentivoglio, A. Fasano, T. Ialongo, F. Soleti, S. Lo Fermo, A. Albanese

Research output: Contribution to journalArticle


Background and purpose: To review the clinical characteristics and the long-term outcome of patients with hemifacial spasm (HFS) who received botulinum neurotoxin (BoNT) over the past 10 years. Results: A total of 108 patients received 665 treatments. Mean latency of clinical effect was 5.4 ± 5.3 days for Botox and 4.9 ± 4.6 days for Dysport (P > 0.05). Mean duration of clinical improvement was higher after the injection of Dysport than Botox: 105.9 ± 54.2 and 85.4 ± 41.6 days respectively (P <0.01). The percentage of treatment failures was 6.5% for Botox and 4.6% for Dysport (P > 0.05). The doses of Botox significantly increased over time (β = 0.35, P <0. 001) whilst Dysport dose remained unchanged (β = 0.16, n.s.). The duration of clinical benefit slightly increased with Botox (β = 0.12; P <0.01), but remained constant for Dysport. Side effects occurred in 17.4% of treatments: 16.7% of patients who had received Botox, and in 19.7% who had received Dysport (P > 0.05). The most common side effects were palpebral ptosis and lacrimation; ptosis and lagophtalmos was more common in Dysport treatments (P <0.005). Conclusions: Both brands are effective and safe in treating HFS; efficacy is long-lasting. The differences in outcome and side effects confirm that, albeit the active drug is the same, Botox and Dysport should be considered as two different drugs.

Original languageEnglish
Pages (from-to)392-398
Number of pages7
JournalEuropean Journal of Neurology
Issue number3
Publication statusPublished - Mar 2009


  • Botox
  • Botulinum neurotoxin
  • Dysport
  • Hemifacial spasm
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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