Objective: To assess barriers to treatment and outcomes of botulinum toxin in patients treated for Hemimasticatory spasm

Background: Hemimasticatory spasm (HMS) is a rare peripherally induced movement disorder.

Method: We conducted a retrospective study of patients with HMS presenting from October 2008 to February 2022.  All patients were contacted for a telephonic interview. Six of the seven patients gave the telephonic interview. One could not be contacted despite best efforts.

Results: The prevalence of HMS as 0.10% at our centre from Oct 2008 till Feb 2022. The most common symptoms (Table 1) were a locked jaw (85.7%), followed by brief unilateral muscle twitches or spasms (71.4%), tongue bites (71.4%) and severe pain on the affected side (57.1%). Common triggers were talking and laughing, followed by exposure to cold and sometimes while chewing food. Average age of onset was 42.5 years (Range 29-55). The average time to diagnosis was 22.6 months (Range 4-36). Four patients (57.1%) were on regular Botulinum toxin Injections (Table 2). The average effect lasted between 16-24 weeks in most cases (66.6%). One patient had a good response but could not continue to take it due to financial reasons. One patient had a response less than 8 weeks once and did not take a repeat injection. The last patient who could not be contacted for the interview had chosen not taken botulinum toxin injections in the past due to financial and logistical reasons.

Conclusion: HMS is a very rare movement disorder. Majority have a good response to Botulinum toxin injections. Early recognition can help relieve the pain and jaw spasms due to this condition.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-study-of-seven-patients-with-hemimasticatory-spasm-barriers-to-treatment-and-outcomes-of-botulinum-toxin/