Evaluating the efficacy of botulinum toxin type a in alleviating neuropsychological symptoms in hemifacial spasm patients.

[OBJECTIVE] To evaluate the efficacy of botulinum toxin type A (BTX-A) in the treatment of neuropsychological symptoms in patients with hemifacial spasm (HFS).

[METHODS] Sixty-three HFS patients with neuropsychological symptoms were randomly assigned in a 1:1 ratio to the BTX-A group ( = 32) and the citalopram hydrobromide (CH) group ( = 31). The BTX-A group was treated with facial injections, while the CH group received oral administration of 20 mg/day. Cornell Medical Index (CMI) scores were assessed before treatment and at 8 weeks after treatment.

[RESULTS] After 8 weeks, the BTX-A group exhibited significant reductions in total CMI scores and scores of the somatization, tension, anxiety, depression, and sensitivity subscales ( < 0.05). The CH group showed significant improvements in total CMI and scores of the somatization, anxiety, depression, sensitivity, anger, and tension subscales ( < 0.05). No significant differences between the two groups were observed in total CMI scores or scores of each CMI subscale ( > 0.05). The overall response rates were 63.3% in the BTX-A group and 70.0% in the CH group, with no significant difference between the two groups ( > 0.05).

[CONCLUSION] BTX-A improves both motor symptoms and short-term neuropsychological symptoms in patients with HFS.