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M.H. Osaki, R. Belfort Jr; Quality of Life in Blepharospasm and Hemifacial Spasm Patients Treated With Botulinum Toxin-A . Invest. Ophthalmol. Vis. Sci. 2003;44(13):159.
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Purpose:This study is intended to evaluate both the costs and the impact on the quality of life of blepharospasm (BS) and hemifacial spasm (HS) patients treated with botulinum toxin-A (BTX-A). Methods:28 patients (16 BS and 12 HS), treated with BTX-A, were evaluated by means of two research tools, namely Medical Outcomes Study Short Form Healthy Survey(SF-36), and Fahn Disability Rating Scale (FDS). The costs were mainly calculated on the basis of the toxin units used by each patient during a one-year period. Results:Patients with essential blepharospasm (BS) are in a higher age group and the disease lasted longer than in patients with hemifacial spasm (HS). No significant differences were encountered between the average ages in BS and HS. On the other hand, the duration of the illness presented statistically significant differences (p= 0.002.) The total estimated direct cost was estimated at 1,081.62 reais per year ( DP +/- 89.39) for BS and 618.06 reais per year (DP +/- 60.06) for HS, at an outpatient level (p < 0.001). Before treatment all domains of SF- 36 were significantly worse in both diseases. Under effective treatment with BTX-A the increase in the indices of SF-36 showed changes in the general health rates of the population under study, with a statistically significant difference between the pre and post answers (p<0.05). In relating SF-36 with FDS, the BS cases showed significant positive relationships ( functional capacity, general health, emotional and social aspects ) while in the HS patients no correlation was found. Conclusions: The present study demonstrates a remarkable negative impact on the quality of life of BS and HS patients, as well as a significant improvement of both diseases after BTX-A treatment. Furthermore, the research data seem to justify BTX-A treatment high costs in view of its considerable benefits for the patients’ quality of life.
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