Objective: To compare effect of cold compression and no cold compression before Botulinum neurotoxin (BoNT) injection on severity, frequency of hemifacial spasm (HFS) and complication after injection. To investigate cold compression effect on pain and bleeding during injection. Quality of life (QoL) before and after treatment were also evaluated.

Background: Botulinum neurotoxin injection is a treatment of choice in hemifacial spasm. There are many studies showed that, using ice compression before injection can significantly decrease bleeding and pain.

Methods: A prospective, randomized, case-crossover design was employed. 159 patients who was diagnosed as primary HFS with BoNT treatment in Prasat Neurological Institute botulinum toxin clinic were randomized during May 2017 to November 2017. We divided into 2 groups with cold compression and no cold compression before BoNT injection then evaluated severity, frequency of HSF by using Jankovic Rating Scale. Complication of treatment, pain, bleeding and QoL were also assessed.

Results: Cold compression before BoNT injection significantly decreased severity and frequency of HFS (p<0.001). Pain scale and bleeding in cold compression before BoNT injection was significantly lower than no cold compression group (p<0.001). [Table.1] QoL was significantly improved after treatment with BoNT (p<0.001). [Table.2]

Conclusions: Cold compression before Botulinum neurotoxin injection can reduce the scale of severity and frequency (Jankovic Rating Scale) faster and more lower. [Figure.1] This study confirms previous studies that cold compression before Botulinum neurotoxin injection had a good outcome in pain scale and bleeding. No significant complications were found. Additionally, Botulinum neurotoxin injection can improved quality of life in hemifacial spasm patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-cold-compression-before-botulinum-neurotoxin-injection-in-hemifacial-spasm/