Evaluating Headache Incidence and Characteristics After Botulinum Toxin Treatment in Blepharospasm and Hemifacial Spasm Patients: A Retrospective Cohort Clinical Study

Clin Neuropharmacol. 2024 Sep-Oct;47(5):157-162. doi: 10.1097/WNF.0000000000000609. Epub 2024 Aug 26.

Abstract

Objectives: The aim of the study is to assess the prevalence and clinical features of headache in patients treated with botulinum toxin for blepharospasm and hemifacial spasm. In addition, our secondary aim was to identify potential factors influencing the development of these headaches.

Methods: A total of 70 patients who were treated with on a botulinum toxin A for dystonia treatment in our clinic between January 2023 and March 2023 were retrospectively screened, and the clinical and demographic characteristics of the patients who reported headache complaints after the last botulinum toxin treatment were examined.

Results: Headache was reported in 8 (%11.4) of the 70 patients included in the study. Of the 8 patients who reported headaches, 6 (%75) had the onset of the complaint within the first 24 hours. There was no significant correlation between headache occurrence and factors like age, gender, diagnosis, botulinum toxin dosage, application site, comorbid diseases, or hypertension. However, a statistically significant link was observed between the intensity of pain experienced during treatment and the frequency of headaches after the treatment.

Conclusions: Botulinum toxin treatment can lead to short-term headaches in some patients, starting early after the procedure. The significant link between the frequency of these headaches and the pain experienced during injection highlights the need to examine factors like the volume and dilution rate of the toxin, the solvent used, treatment area, treatment purpose, patient characteristics, and the physician's technique. It is important to study these aspects by comparing them across a large patient group and control subjects.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blepharospasm* / drug therapy
  • Blepharospasm* / epidemiology
  • Botulinum Toxins, Type A* / administration & dosage
  • Botulinum Toxins, Type A* / adverse effects
  • Botulinum Toxins, Type A* / therapeutic use
  • Cohort Studies
  • Female
  • Headache* / chemically induced
  • Headache* / drug therapy
  • Headache* / epidemiology
  • Hemifacial Spasm* / drug therapy
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neuromuscular Agents / adverse effects
  • Neuromuscular Agents / therapeutic use
  • Retrospective Studies

Substances

  • Botulinum Toxins, Type A
  • Neuromuscular Agents