Background and Objectives: The COVID-19 pandemic triggered significant delays in the treatment of people with movement disorders who depend on face-to-face clinic encounters for receipt of their regular botulinum toxin injections. Against this background, it was the aim of this study to look into pandemic-related characteristics of patients with dystonia and hemifacial spasm treated with botulinum toxin at a tertiary centre in Romania and identify potential correlations between delays in treatment and health perceptions.
Materials and Methods: A cross-sectional, questionnaire-based, study was conducted between May-September 2021 on the 175 patients in the centre’s botulinum toxin database.
Results: Of the 90 patients who qualified for inclusion most were late middle-aged females with long-standing dystonia, of which torticollis and blepharospasm were the most common phenotypes. Treatment was delayed by an average of 8.5 months, whereas the overall quality-of-life health score was 61.1, with 60% of respondents rating themselves above 50. No statistically significant correlation was identified between delays in treatment and overall healthscores. Instead, statistically significant differences were uncovered based on type of disorder (dystonia vs. hemifacial spasm).
Conclusion: The results of this study may go on to show that, in the event of similar pandemic surges, patient micromanagement by type of disorder may be part of a well-balanced restriction-cum-access health policy.

Repetitive transcranial magnetic stimulation (rTMS) is a relatively new therapeutic and diagnostic technique that uses non-invasive neuromodulation and has an excellent safety profile[1]. According to recent EAN guidelines on central neurostimulation in chronic pain conditions there is only week evidence for primary motor cortex rTMS in neuropathic pain[2], while other guidelines on rTMS state a defi nite analgesic effect of high frequency rTMS of the primary motor cortex contra-lateral to pain site in neuropathic pain[3]