Headache in hemifacial spasm patients

Objectives To assess prevalence of headaches in patients with hemifacial spasm. To determine whether hemifacial spasm provokes headaches and identifies predictive factors. To evaluate whether botulinum toxin given for hemifacial spasm improves headaches. Methods Seventy patients with hemifacial spasm were evaluated for headaches. The relationship of headaches with hemifacial spasm, impact on quality of life (HIT-6), and improvement in headaches from botulinum toxin was recorded. Data on duration, severity, and impact on quality of life (HFS-7) of hemifacial spasm were collected. Results Hemifacial spasm-related headache was significantly associated with increased hemifacial spasm severity (P<0.001) and HIT-6 (P=0.024). Greater hemifacial spasm severity was predictive of hemifacial spasm-related headache (P=0.006, OR 19.1, 95% CI 2.35155.64). Botulinum toxin (BTX) for hemifacial spasm improved hemifacial spasm-related headaches (P<0.001). Conclusions Hemifacial spasm can complicate headaches, particularly in patients with greater hemifacial spasm severity. Individually tailored regimens of botulinum toxin may be indicated in these patients.