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Acta Neurologica Belgica

, Volume 119, Issue 1, pp 55–60 | Cite as

Evaluation of stigmatization in hemifacial spasm and quality of life before and after botulinum toxin treatment

  • Burcu YukselEmail author
  • Fatma Genc
  • Aylin Yaman
  • Eylem Ozaydin Goksu
  • Pelin Dogan Ak
  • Yasemin Bicer Gomceli
Original Article
  • 38 Downloads

Abstract

Hemifacial spasm (HFS) is a chronic disease that is characterized by involuntary tonic and clonic contractions of the muscles innervated by the ipsilateral facial nerve. Botulinum toxin (BTX) is the most effective medical treatment of this condition. The aim of our study was to evaluate stigma among patients diagnosed with HFS and to search quality of life and depression before and after BTX injection. Seven self-rating items (HFS-7) and seven questions related to stigmatization were administered to HFS patients. Participants also answered SF-36 health outcome measure and Beck depression inventory before and 4 weeks after the routine BTX injection. The severity of HFS was graded based on a five-point scale. Descriptive statistics and paired t test were applied. The level of significance was set at α = 0.05. Fourty HFS patients were prospectively included. Twenty-one (%52.5) were female and nineteen were male (47.5%) with a mean age of 57.1 (SD = 12.13; min–max = 27–78). 60% (n: 24) of patients were feeling themselves different from people without HFS. Beck depression inventory scores improved after BTX injection significantly (p < 0.05). All domains of SF-36 showed positive improvement after BTX injections. The improvement in general health perception, physical functioning, and vitality was statistically significant (p < 0.05). Although more than half of the patients felt themselves different from people without HFS, treatment of HFS with BTX significantly improved mental health and physical health, and depressive symptoms of the patients.

Keywords

Stigma Hemifacial spasm Quality of life Depression Botulinum toxin 

Notes

Acknowledgements

The authors thank Ass. Prof. Dilek Atakli for sharing her questions related to stigmatization and Prof. Hakan Yaman for his contribution.

Funding

No funding was received for this study. This research did not receive any grant from funding agencies.

Compliance with ethical standards

Conflict of interest

There is nothing to declare as a competing interest for any of the authors including the corresponding author.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by ethics committee and informed consent was obtained from all individual participants included in the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Chaudhry N, Srivastava A, Joshi L. Hemifacial spasm: the past, present and future. J Neurol Sci (2015).  https://doi.org/10.1016/j.jns.2015.06.032 Google Scholar
  2. 2.
    Abbruzzese G, Berardelli A, Defazio G (2011) Hemifacial spasm. Handb Clin Neurol 100:675–680.  https://doi.org/10.1016/B978-0-444-52014-2.00048-3 CrossRefGoogle Scholar
  3. 3.
    Tan EK, Fook-Chong S, Lum SY et al (2004) Botulinum toxin improves quality of life in hemifacial spasm: validation of a questionnaire (HFS-30). J Neurol Sci 219:151–155CrossRefGoogle Scholar
  4. 4.
    Tan EK, Chan LL, Koh KK et al (2005) Behind the facial twitch: depressive symptoms in hemifacial spasm. Parkinsonsim Relat Disord 11:241–245CrossRefGoogle Scholar
  5. 5.
    Ak PD, Atakli D, Yuksel B et al (2015) Stigmatization and social impacts of epilepsy in Turkey. Epilepsy Behav 50:50–54CrossRefGoogle Scholar
  6. 6.
    Van der Beek KM, Bos I, Middel B et al (2013) Experienced stigmatization reduced quality of life of patients with a neuromuscular disease: a cross-sectional study. Clin Rehabil 27(11) 1029–1038CrossRefGoogle Scholar
  7. 7.
    Scambler G (1998) Stigma and disease: changing paradigms. Lancet 352:1054–1055CrossRefGoogle Scholar
  8. 8.
    Gray AJ (2002) Stigma in psychiatry. J R Soc Med 95(2):72–76CrossRefGoogle Scholar
  9. 9.
    Çam O, Çuhadar D (2012) Bipolar bozukluğu olan hastalarda işlevsellik düzeyi ve damgalama arasındaki ilişkinin belirlenmesi. Gümüşhane Üniversitesi Sağlık. Bilimleri Dergisi 2:230–246Google Scholar
  10. 10.
    Çam O, Bilge A (2013) Türkiye’de Ruhsal Hastalığa/Hastaya Yönelik İnanç, Tutum ve Damgalama Süreci: Sistematik Derleme. Psikiyatri Hemşireliği Dergisi J Psychiatr Nurs 4(2):91–101CrossRefGoogle Scholar
  11. 11.
    Huang YC, Fan JY, Ro LS, Lyu RK, Chang HS, Chen ST, Hsu WC, Chen CM, Wu YR (2009) Validation of a Chinese version of disease specific quality of life scale (HFS-36) for hemifacial spasm in Taiwan. Health Qual Life Outcomes 7:104.  https://doi.org/10.1186/1477-7525-7-104 CrossRefGoogle Scholar
  12. 12.
    Prisnie JC, Sajobi TT, Wang M, Patten SB, Fiest KM, Bulloch AGM, Pringsheim T, Wiebe S, Jette N (2018) Effects of depression and anxiety on quality of life in five common neurological disorders. Gen Hosp Psychiatry 52:58–63.  https://doi.org/10.1016/j.genhosppsych.2018.03.009 (epub 2018 Apr 4) CrossRefGoogle Scholar
  13. 13.
    Singh S (2013) Botulinum toxin in hemifacial spasm: revisited. Indian J Plast Surg 46(1):159–160CrossRefGoogle Scholar
  14. 14.
    Yaltho TC, Jankovic J (2011) The many faces of hemifacial spasm: differential diagnosis of unilateral fcial spasms. Mov Disord 26(9):1582–1592.  https://doi.org/10.1002/mds.23692 (epub 2011 Apr 5) CrossRefGoogle Scholar
  15. 15.
    Jankovic J, Schwartz K, Donovan DT (1990) Botulinum toxin treatment of cranial-cervical dystonia, spasmodic dysphonia, other focal dystonias and hemifacial spasm. J Neurol Neurosurg Psychiatry 53:633–639CrossRefGoogle Scholar
  16. 16.
    Tan EK, Fook-Chong S, Lum SY, Thumboo J (2005) Validation of a short disease specific quality of life scale for hemifacial spasm: correlation with SF-36. J Neurol Neurosurg Psychiatry 76(12):1707–1710CrossRefGoogle Scholar
  17. 17.
    Ware JE Jr, Snow KK, Kosinski M et al (1993) SF-36 Health Survey manuel and interpretation guide. Nimrod, BostonGoogle Scholar
  18. 18.
    Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A (1999) Kısa form-36 (KF36)’nın Türkçe versiyonunun güvenirliliği ve geçerliliği. İlaç ve Tedavi Dergisi 12(2):102–106Google Scholar
  19. 19.
    Hisli N (1989) Beck Depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji dergisi 7:3–13Google Scholar
  20. 20.
    Scambler G (1989) Epilepsy. Tavistock, LondonGoogle Scholar
  21. 21.
    McCagh J (2009) Epilepsy, psychosocial and cognitive functioning. Epilepsy Res 86:1–14CrossRefGoogle Scholar
  22. 22.
    Suurmeijer TP, Reuvekamp MF, Aldenkamp BP (2001) Social functioning, psychological functioning, and quality of life in epilepsy. Epilepsia 42(9):1160–1168CrossRefGoogle Scholar
  23. 23.
    Rusch N, Angermeyer MC, Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20(8):529–539CrossRefGoogle Scholar
  24. 24.
    Alonso J, Buron A, Bruffaerts R et al (2008) Association of per- ceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys. Acta Psychiatr Scand 118(4):305–314CrossRefGoogle Scholar
  25. 25.
    Kyra M, van der Beek, Bos I, Middel B, Wynia K (2013) Experienced stigmatization reduced quality of life of patients with a neuromuscular disease: a cross-sectional study. Clin Rehabil 27(11) 1029–1038.  https://doi.org/10.1177/0269215513487234 CrossRefGoogle Scholar
  26. 26.
    Josh WH, Kohl A (2001) Botulinum toxin: evidence based medicine criteria in blepharospasm and hemifacial spasm. J Neurol 248:21–24 (Suppl.) CrossRefGoogle Scholar
  27. 27.
    Streitová H, Bareš M (2014) Long-term therapy of benign essential blepharospasm and facial hemispasm with botulinum toxin A: retrospective assessment of the clinical and quality of life impact in patients treated for more than 15 years. Acta Neurol Belg 114(4):285–291.  https://doi.org/10.1007/s13760-014-0285-z (epub 2014 Mar 7) CrossRefGoogle Scholar
  28. 28.
    Jinnah HA, Berardelli A, Comella C, Defazio G, Delong MR, Factor S, Galpern WR, Hallett M, Ludlow CL, Perlmutter JS, Rosen AR, Dystonia Coalition Investigators (2013) The focal dystonias: current views and challenges for future research. Mov Disord 28(7):926–943.  https://doi.org/10.1002/mds.25567 CrossRefGoogle Scholar
  29. 29.
    Defazio G, Abbruzzese G, Livrea P, Berardelli A (2004) Epidemiology of primary dystonia. Lancet Neurol 3:673–678CrossRefGoogle Scholar
  30. 30.
    Broocks A, Thiel A, Angerstein D, Dressler D (1998) Higher prevalence of obsessive-compulsive symptoms in patients with blepharospasm than in patients with hemifacial spasm. Am J Psychiatry 155(4):555–557CrossRefGoogle Scholar
  31. 31.
    Bao F, Wang Y, Liu J, Mao C, Ma S, Guo C, Ding H, Zhang M (2015) Structural changes in the CNS of patients with hemifacial spasm. Neuroscience 289:56–62.  https://doi.org/10.1016/j.neuroscience.2014.12.070 (epub 2015 Jan 14) CrossRefGoogle Scholar
  32. 32.
    Shimizu M, Suzuki Y, Kiyosawa M, Wakakura M, Ishii K, Ishiwata K, Mochizuki M (2012) Glucose hypermetabolism in the thalamus of patients with hemifacial spasm. Mov Disord 27(4):519–525.  https://doi.org/10.1002/mds.24925 (epub 2012 Feb 16) CrossRefGoogle Scholar
  33. 33.
    Tan EK, Chan LL, Koh KK (2004) Coexistent bepharospasm and hemifacial spasm: overlapping pathophysiologic mechanism? J Neurol Neurosurg Psychiatry 75:494–496CrossRefGoogle Scholar
  34. 34.
    Dias FM, Doyle F, Kummer A, Cardoso F, Fontenelle LF, Teixeira AL (2010) Frequency of psychiatric disorders in blepharospasm does not differ from hemifacial spasm. Acta Neuropsychiatr 22:223–227.  https://doi.org/10.1111/j.1601-5215.2009.00436.x CrossRefGoogle Scholar
  35. 35.
    Rudzińska M, Wójcik M, Malec M et al (2012) Factors affecting the quality of life in hemifacial spasm patients. Neurol Neurochir Pol 46(2):121–129Google Scholar
  36. 36.
    Setthawatcharawanich S, Aui-aree N, Limapichart K, Satirapunya P, Phabphal K (2008) The validation of the disease-specific questionnaire for health-related quality of life in Thai patients with hemifacial spasm. J Med Assoc Thai 91(11):1691–1697Google Scholar

Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  1. 1.Neurology DepartmentAntalya Training and Research HospitalAntalyaTurkey
  2. 2.Neurology DepartmentFatih Sultan Mehmet Training and Research HospitalIstanbulTurkey

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