6th Edition of Neurology World Conference 2026

Abstract

Background: Hemifacial spasm (HFS) is a chronic neuromuscular disorder marked by involuntary facial muscle contractions. Botulinum toxin type A (BoNT-A) is the most effective symptomatic treatment and the Jankovic Rating Scale (JRS) is a validated tool for assessing treatment response. Despite the widespread use of BoNT-A in Sri Lanka, locally published clinical outcome studies on JRS scoring are not widely reported. Objective: To assess the effectiveness of BoNT-A in improving clinical symptoms of HFS using JRS scores in a Sri Lankan clinical setting. Methods: A retrospective analysis was conducted among 98 patients (48 males and 50 females) with primary HFS attending the Neurophysiology clinic at the Teaching Hospital Peradeniya. JRS scores were recorded before treatment and at 1 week, 1 month, and 2 months after BoNT-A injection. Repeated measures ANOVA assessed changes over time, and Bonferroni-adjusted pairwise comparisons identified significant differences between time points. Results: There was a statistically significant change in JRS scores across the four time points (p < 0.001). Mean scores significantly improved from 5.47 at baseline to 2.72 at 1 week (p<0.001). No significant difference was observed between 1 week and 1 month (p = 0.839), indicating sustained early improvement. Scores significantly increased at 2 months compared with both 1 week (p = 0.002) and 1 month (p = 0.008), reflecting gradual loss of therapeutic effect. Adverse effects were minimal and self-limiting. Conclusion: BoNT-A is effective and well tolerated in the management of HFS, while the JRS serves as a practical and reliable method for monitoring treatment outcomes over time.