Publication:

Assessment of health related quality of life in patients with hemifacial spasm

Background There is paucity of literature regarding health related quality of life in hemifacial spasm (HFS) especially from India. Little is known about the clinical and demographic factors associated with poor HRQoL and depression in these patients. This study assessed HRQoL in its global and disease specific aspect by previously validated instruments.

Methods The study was performed in AIIMS, New Delhi. Subjects with hemifacial spasm as well as age and gender matched healthy controls were enrolled from movement disorder and Botulinum toxin clinic, department of neurology, AIIMS, New Delhi. Uneducated patient, those could not read questionnaires, cases that had associated other neurological or debilitating systemic disorders, secondary/pediatrics dystonias, pregnancy or received botulinum toxin within 6 months or underwent surgical treatment were excluded from the study.

Results Total 102 hemifacial spasm patients were included for study. There was no significant difference in demographic details between patients with dystonia and respective control. All patients with HFS scored significantly worse in all the eight domains of the SF-36 as compared with age and sex matched control population (P <0.001). Among HFS patients 36.27% have no depression, while 63.73% have depression. Among them   23.53% had mild and 23.5% had moderate to severe depression. All patients with hemifacial spasm scored significantly worse in all the 11 subscales of the NEI-VFQ-25 including general vision, ocular pain, near vision, distance vision, social functioning, mental health, role difficulties, dependency, driving and peripheral vision (p <0.001)  while no significant  difference (p = 0.199) in score  was observed in colour vision as compared with age and sex matched control population.

Conclusions This study clearly demonstrated that patients with hemifacial spasm, suffered from significant impairment in HRQoL as compared to controls. Higher proportion of patients with HFS suffered from moderate to severe depression compared to their control. Patients with HFS had severe impairment of vision related quality of life. This study indicates that psychological counseling of patients, their family members and treatment aiming to treat depression may be a part of comprehensive treatment approach for these patients.