A cross-sectional structured survey of patients receiving botulinum toxin type A treatment for blepharospasm

To characterize satisfaction with current standard-of-care botulinum neurotoxin type A (BoNT/A) treatment for blepharospasm, we performed a cross-sectional, structured survey in subjects with blepharospasm who had received 2 BoNT/A cycles. Subjects were interviewed immediately before re-injection to evaluate treatment satisfaction, time course of treatment effects, preferred injection intervals, Jankovic Rating Scale (JRS), and Blepharospasm Disability Index (BSDI). Subjects' (n = 114) last treatment was onabotulinumtoxinA (n = 78), incobotulinumtoxinA (n = 35), or abobotulinumtoxinA (n = 1). The most frequent injection interval was 12 weeks (46.5% subjects); 30.7% had an interval > 12 weeks. The main rationale for interval choice was "to maintain treatment efficacy" (44.7%). However, 36.6% reported that treatment effects usually declined within 8 weeks; 69.6% within 10 weeks. JRS and BSDI scores indicated re-emergence of symptoms before re-injection, with 70.2% and 73.7% of subjects reporting difficulties to drive and read, respectively. Overall, treatment satisfaction was high, but declined at the end of the cycle. Many subjects (52.3%) would prefer an injection interval of <12 weeks; 30.6% of <10 weeks. In conclusion, the survey results indicate that blepharospasm symptoms, such as difficulties to drive and read, re-emerge at the end of a BoNT treatment cycle and that flexible, individualized treatment intervals may improve treatment satisfaction and outcomes. (C) 2016 The Authors. Published by Elsevier B.V.