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The total energy generated during spontaneous eyelid movements was significantly reduced after treatment in the BSP patients (p = 0.0018) and on the affected side in the HFS (p = 0.0058) patients. CONCLUSIONS The assessment of the energy generated by the upper eyelid during spontaneous eyelid movements enabled us to measure the therapeutic effects of botulinum toxin in patients with these conditions. The use of this system could enable customized and fine adjustments to botulinum toxin doses based on each patient's needs. This article is protected by copyri