The first sessions occurred every three to six months from February 1999 through March 2003. A well-respected neurologist who specialized in treatment of Parkinson’s Disease injected Botox® into numerous locations surrounding my left eye lid, nasolabial fold and cheek. The Botox® dramatically reduced the visible effects of my hemifacial spasms. However, there were also some adverse responses to the Botox® as well. My left eye would drip tears continually, so that I was constantly wiping tears from my cheek. My mouth drooped to the point where I had a noticeably crooked smile. Following each series of injections, people often thought that I was recovering from a stroke.

This was an unsatisfactory result, so I discontinued Botox® treatment in the spring of 2003 with the intention of having a MVD. But although I was approved for the operation, by a surgeon who had studied under Dr. Peter Jannetta, after extensive consultation with expert medical personnel I decided that I would not go through with brain surgery due to potential serious complications which sometimes occur. In particular, I felt that losing my hearing or having a continuous ringing or roaring sound in my ears (which some people had experienced post operation) was an alternative that would be even worse than having spasms.

So, I sought Botox® treatment once again, but this time I went to a different practitioner who was reputed to be one of the most skilled physicians in the country in the use of Botox® to alleviate symptoms of facial movement disorders. Dr. Gary E. Borodic, a Harvard Medical School professor and clinician at Massachusetts Eye and Ear Infirmary, has treated over 1000 patients with HFS. When I arrived for my first visit with him and he handed me an 11-page manual describing his techniques for reducing “involuntary synkinetic movement of facial muscles,” I knew I was in a very different doctor’s office. Dr. Borodic explained that in order to be effective, both the specific dosage and the exact location of the injections must be controlled within very tight parameters. He added that incorrect administration of Botox® can result in substantial disfigurement and that it is this poorly managed treatment that has sometimes given Botox® a bad reputation.

Dr. Borodic injected a small amount of Botox® in just three locations. As is usually the case, the full effects of this treatment did not show up until about 10 days following the injections. But from that point until now (a month later) my appearance has been so normal that people aren’t aware of my spasms. Even my wife (who used to sometimes hug me with tears in her eyes she was so distressed by my facial appearance) cannot tell if I was having spasms. I can give lectures, counsel clients and attend social occasions without any concerns. I feel as though I have been freed from an evil curse and can once again live as fully as before. In the past, my spasms had been strong enough to close my left eye tightly and to pull my mouth, cheek and neck towards my left ear in 20 second periods of tonus, making me look positively demented. So, the change in my appearance has been spectacular.

The purpose of Botox® treatment is to relieve symptoms of Hemifacial Spasm, not to cure it. Right now, during the first 45 days when the Botox® is having its maximum benefit, although my appearance is normal, I can sometimes still feel the spasms. I need to stress that although I feel this and am aware of it, others don’t seem to notice it at all (not even my wife and children). I am freed from the social embarrassment but not left unaware that I still have HFS. In three to six months, I will need a subsequent Botox® treatment, and this routine will need to continue into the indefinite future.

Dr. Borodic has explained that over a period of years, some people develop a full or partial immunity to Botox®. If this happens, I will be able to continue treatment with Dr. Borodic because he has developed (and patented) an alternate medication which can be effective for people who no longer respond to conventional Botox®.

The most important thing I have learned from my Botox® treatment experiences is that there is a huge difference between practitioners. Both of the physicians I used were considered experts, yet the results of their Botox® treatment were radically different.