Facial Spasm:

tics de la face : évaluation de l'acupuncture

1. Systematic Reviews and Meta-Analysis

☆☆☆	Evidence for effectiveness and a specific effect of acupuncture
☆☆	Evidence for effectiveness of acupuncture
☆	Limited evidence for effectiveness of acupuncture
Ø	No evidence or insufficient evidence

1.1. Wang 2013 ☆

Wang Jun, Deng Junhong, Zhang Jianfeng (Zhidao). [Meta-analysis on randomized controlled trials of acupuncture in treating facial spasm]. Western Journal of Traditional Chinese Medicine 2013;8:61-63. [187060].

Objectives	To assess the effectiveness of randomized controlled and controlled clinical trial of acupuncture in treating facial spasm.
Methods	The related literature about acupuncture in treating facial spasm included randomized controlled trial (RCT) and controlled clinical trial (CCT) were retrieved in WanFang database (WF) and CNKI from January, 2000 to January, 2013, the quality of included researches were evaluated with Cochrane systematic evaluation methodology. Meta-analysis was performed with Review Manager Software 5. 1.
Results	There were six articles meeting the included criteria, Meta-analysis of 843 patients showed that the comparison between acupuncture and drug for facial spasm demonstrated the difference with statistical meaning [complicated with OR (fixed effect model) =7. 74, 95%CI (4. 89, 12. 24), tested with Z, Z=8. 74, P<0. 00001].
Conclusions	Clinical efficacy of acupuncture in treating facial spasm is superior to the drugs, but it still needs more large-sample RCT to be verified, the design level of clinical research on acupuncture needs to be improved further.

1.2. Wang 2012 ☆

Wang QP, Bai M, Lei D. Effectiveness of Acupuncture in Treatment of Facial Spasm: A Meta-Analysis. Altern Ther Health Med 2012;18(3):45-52. [166230].

Objectives	CONTEXT: Facial spasm is one of the common facial diseases, especially in the aged. It is mostly characterized by initially progressive, involuntary, irregular, recurrent, clonic, or tonic movements of muscles innervated by the facial nerve on one side. Acupuncture is a low-risk treatment with purported claims of effectiveness for facial spasm. OBJECTIVE: To assess the efficacy of acupuncture in facial spasm comprehensively.
Methods	DESIGN: The research team conducted a systematic review and meta-analysis of all randomized clinical trials (RCTs) that examined the effectiveness of acupuncture for facial spasm. OUTCOME MEASURE(S): The research team categorized results from each of the reviewed studies in two ways: (1) the number of participants who showed a positive response to therapy (total effectiveness rate) and (2) the number of participants who made a full recovery (clinical cure rate).
Results	The research team reviewed a total of 13 studies involving 1262 participants with facial spasm. Researchers in China had conducted all studies, and most studies were poor in methodological quality. All studies reported that acupuncture was superior to other treatments, including carbamazepine, mecobalamin, and massage, and the meta-analysis on these low-quality studies yielded similar results.
Conclusions	Present trials evaluating the efficacy of acupuncture in treatment of facial spasm are mostly poor in methodological quality. These studies showed that acupuncture was superior to other treatments for facial spasm; however, in its meta-analysis, the research team could not draw an affirmative conclusion as to the benefits of acupuncture due to the poor methodological quality and localized population of the included trials. The field needs large international, well-conducted RCTs.

2. Overview of systematic reviews

2.1. Gong 2022 ☆

Gong Y, Li X, Zhou X, Pan T, Wang H, Chen C, Wang J, Wang S, Chen X. Acupuncture treatment of facial spasm: An overview of systematic reviews. Medicine (Baltimore). 2022 Dec 16;101(50):e32182. https://doi.org/10.1097/MD.0000000000032182

Background	To provide evidence, this review evaluated the methodological quality, risk of bias, and reporting quality of SRs/MAs in the treatment of Facial Spasm with acupuncture.
Methods	Systematic reviews and Meta analyses (SRs/MAs) of acupuncture for Facial Spasm were retrieved from 8 databases from inception to October 1, 2022. Two reviewers independently screened the literature and extracted the data, then used Assessment of Multiple Systematic Reviews-2 (AMSTAR-2), Bias Risk in Systematic Review (ROBIS), and Preferred Report Item for Systematic review and Meta-analysis (PRISMA), Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to assess methodological quality, risk of bias, quality of reporting, and quality of evidence.
Results	A total of 8 SRs/meta-analyses were included. All the SRs were published between 2012-2022. Based on AMSTAR-2, 8 SRs were rated critically low quality. By using the ROBIS tool, 6 SRs were rated low-risk bias. With the PRISMA-A checklist, we found 2 out of 8 SRs were found adequately reported over 70%. With the GRADE system, no high-quality evidence was found, and only two outcomes provided moderate-quality evidence. Among the downgraded factors, the risk of bias within the original trials was ranked first, followed by publication bias, inconsistency, and imprecision.
Conclusion	Acupuncture is a promising complementary treatment for HFS. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples are needed before widespread recommendations can be made.

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