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


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.


Stigma Hemifacial spasm Quality of life Depression Botulinum toxin 



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


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.


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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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