An objective assessment of Botulinum toxin type A injection in the treatment of post facial palsy synkinesis and hyperkinesis using the Synkinesis Assessment Questionnaire (SAQ)

Neville C, Aslett M, Venables V, Nduka C, Kannan R.Journal of Plastic Reconstructive & Aesthetic Surgery · June 2017. DOI: 10.1016/j.bjps.2017.05.048



The aim of this study is to provide reliable and valid evidence that Botulinum toxin (BTX-A) is a successful treatment for facial synkinesis in facial palsy using the synkinesis assessment questionnaire tool (SAQ). 51 patients completed questionnaires pre and post BTX-A treatment over 103 cycles of treatment. Each patient was individually assessed and then treated according to their presenting symptoms with a dosage in each injection site of between 0.5 to 5 U of BTX-A. A two-tailed, paired samples t-test was used to compare the scores for each question before and after treatment. A significant difference was found between all scores before and after treatment at the level of p < 0.05. As well as an improvement in mean score in the post treatment group there was also a smaller spread of scores in the post-treatment group compared to the pre-treatment group. The study showed that SAQ scores decreased significantly for every question on the SAQ after treatment. This indicates that BTX-A is an effective treatment for synkinesis adding further weight to current evidence. The study also indicated that BTX-A continues to be effective even after three rounds of treatment, with a significant decrease in overall scores after each treatment cycle.