ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Botulinum toxin modulates the blink reflex via the trigeminal afferent system in hemifacial spasm: an early and late-term effect.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Sustained remission following repeated onabotulinumtoxinA treatment in primary hemifacial spasm: a case series.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Long-term neuromuscular alterations during botulinum toxin treatment for chronic migraine.Clinical neurophysiology practice · 2026Article
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Abstract
backgroundThere is growing evidence that botulinum neurotoxin (BoNT) can mediate changes at the central level through peripheral mechanisms, leading to alterations in central sensorimotor integration. However, the effect of BoNT on brainstem excitability in patients with hemifacial spasm(HFS) is not yet fully understood, and its long-term effects remain unknown.
objectiveThis study aims to investigate the impact of BoNT on the excitability of the facial nucleus in patients with idiopathic HFS.
methodsIn order to evaluate the peripheral effect of the toxin, the amplitude of compound muscle action potential (CMAP) of orbicularis oculi (OOc) muscles was evaluated. To investigate the effects of locally injected BoNT on the brainstem, particularly the facial motor nucleus, we evaluated the amplitude and latency of the blink reflex (BR), the synkinetic responses (SR) and the ratio of contralateral R2 (cR2) amplitude of BR/CMAP amplitude in 16 patients with HFS. These measurements were performed before and after the 1 and 4 month BoNT injection.
resultsFollowing BoNT therapy there was a significant amplitude reduction and latency prolongation of R1, iR2, cR2 and SR elicited by the stimulation of the side of BoNT injection. The mean CMAP amplitude of OOc muscle was significantly lower after BoNT injection. The ratio of cR2 amplitude/CMAP amplitude of OOc showed a significant decline after BoNT therapy.
conclusionOur study demonstrated that BoNT suppresses the excitability of facial motor neurons in idiopathic HFS via the trigeminal afferent mechanism. These effects persisted during the fourth month, despite BoNT's diminished activity.
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