40 Patients with essential blepharospasm (accompanied by oromandibular dystonia in 16) and 10 with hemifacial spasm underwent treatment with local botulinum toxin type A injections and were followed up for mean periods of 192 (64-324) and 161 (58-324) days. All patients with hemifacial spasm and 80% of those with blepharospasm improved by more than 50% on the various rating scales used in this study and benificial effects following a singe set of injections lasted for a mean of 68 and 80 days in cases of blepharospasm and hemifacial spasm, respectively. Repeat injections were similarly effective in all but three cases of blepharospasm in whom an initially good response could not be reproduced. Transient ptosis was the most prevalent among the local side effects encountered and was present in mild or moderate intensity in almost 50% of the patients with blepharospasm and 30% of those with hemifacial spasm, while diplopia and lower facial palsies occurred in 6% and 18% of all treated cases. The results of this series are in good agreement with those published in earlier reports and confirm that local injections of botulinum toxin are a safe and effective treatment for both conditions.