Objective: To retrospectively analyze the clinical characteristics of patients with hemifacial spasm who received botulinum toxin type A (BTX-A) injection.

Methods: A retrospective study was conducted in 245 patients with hemifacial spasm who received BTX-A injection in a single center. The demographic and clinical characteristics were analyzed, and the correlations with Cohen’s scale and the efficacy of BTX-A injection was analyzed.

Results: Among 245 patients with hemifacial spasm, 159 patients (64.9%) were females with an average age of 54.2 ± 10.3 years; 86 patients (35.1%) were males, with an average age of 48.3 ± 8.6 years. Left hemifacial spasm was seen in 137 patients (55.9%), including 97 females (61.8% of female patients, 97/159) and 40 males (46.5% of male patients, 40/86). According to Cohen’s scale, 51 (20.8%) had mild spasm, 194 (79.2%) had moderate-severe spasm; compared with mild spasm, patients with moderate-severe spasm had older age (P = 0.021) and longer course of disease (P = 0.012). The average injection dose of BTX-A in mild hemifacial spasm patients was 35.5 ± 5.2 U, and the average duration of efficacy was 145.5 ± 36.1 d; the average injection dose of BTX-A in patients with moderate-severe hemifacial spasm was 40.2 ± 5.8 U, and the average duration of efficacy was 137.8 ± 34.5 d. Four weeks after treatment, the total response rate was 96.3%, and the visual analog scale (VAS) score of treatment satisfaction was 75%.

Conclusion: The prevalence of hemifacial spasm in females is significantly higher than that in males, and the proportion of left side involvement is also higher than that of males; patients with moderate-severe hemifacial spasm accounts for a high proportion, and is related to clicking sounds in the ipsilateral ear. All patients had good response to BTX-A injection with less adverse reactions, so as to significantly improve the quality of work and life.