BOTULINUM TOXIN TYPE A IN THE MANAGEMENT OF FACIAL MUSCLE SPASMS IN ADULTS: A LITERATURE REVIEW OF CLINICAL INDICATIONS, THERAPEUTIC EFFICACY AND LIMITATIONS

Abstract

Facial muscle spasms comprise motor disorders that may impair facial expression, functional activities, social interaction and quality of life. In this context, botulinum toxin type A has been used as a therapeutic alternative. This study aimed to analyze the available scientific evidence on the use of botulinum toxin type A in the management of facial muscle spasms in adults, considering its clinical indications, therapeutic efficacy, safety and main limitations. This is a narrative literature review with an exploratory and descriptive approach, based on searches in PubMed, SciELO and the Virtual Health Library (BVS) for publications from 2021 to 2026, which gathered 23 publications. The results showed use mainly in hemifacial spasm and blepharospasm, as well as in oromandibular dystonia and specific cases of facial synkinesis, with predominantly favorable therapeutic outcomes and an overall satisfactory safety profile. However, the temporary duration of the effect, the need for repeated applications, variability in clinical response and differences among protocols constitute relevant limitations. It is concluded that botulinum toxin type A represents a relevant therapeutic alternative for facial motor disorders, provided that its indication is based on an appropriate diagnosis, individualized assessment and adequate anatomical and technical knowledge.