Chief & Presenting Author: Dr.Arnab Mandal

Abstract

Hemifacial spasm is a unilateral condition, characterized initially by brief spasm of the orbicularis oculi which later spreads along the distribution of the facial nerve. It is disabling due to social embarrassment and in extreme cases can interfere with vision. Botulinum toxin acts by blocking the release of acetylcholine at the neuromuscular junction. 50 units of botulinum toxin A is reconstituted with 2ml normal saline (0.9%) to make concentration of 2.5units/ml.
60 years old female presented with hemifacial spasm at her left sided face. Injection sites were marked & cleaned. Using 30 gauge needle, each 2.5 units of botulinum toxin was injected to glabella targeting the procerus and corrugator superciliaris, orbital part of orbicularis, upper eyelid into divided dosage, lower eyelid centrally & laterally, zygomaticus major & minor, mentalis and lateral canthus. No side effect was seen post operatively. The patient was asymptomatic on 3 months post injection follow-up.