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      Tratamento do espasmo facial unilateral com toxina botulínica tipo A Translated title: Management of hemifacial spasm with botulinum A toxin

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          Abstract

          RESUMO Este estudo retrospectivo apresenta a experiência no tratamento do espasmo facial unilateral com toxina botulínica tipo A. Dezenove pacientes receberam 71 aplicações. O índice de sucesso foi de 94,4%. A duração média do efeito foi de 17,7 (± 7,2) semanas. A incidência de complicações foi de 35,2% e dose dependente, todas elas locais, transitórias e de grau leve a moderado.

          Translated abstract

          SUMMARY This retrospective study presents the auhor 's experience in the treatment of the hemifacial spasm whit botulinum toxin type A . Nineteen patients received 71 injections. Success rate was 94.4%. The mean duration of effect after the treatment was 17.7 (± 7.2) weeks. The incidence of complications was 35.2% and dose related. All of them were minar, transitories and restricted to the face.

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          Botulinum A toxin for cranial-cervical dystonia: a double-blind, placebo-controlled study.

          We studied the effects of botulinum A toxin in 12 patients with blepharospasm and 10 patients with oromandibular-cervical dystonia received in a double-blind manner. All blepharospasm patients improved, 71.6% on a clinical rating score, 60.7% by self-assessment, and 38.9% by video-rating; there was no improvement with placebo. The beneficial effects lasted a mean of 12.5 weeks (range, 5 to 28). Only 37.5% of the patients with oromandibular-cervical dystonia improved. Patients with pharyngeal dystonia and spasmodic dysphonia also improved.
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            Botulinum A toxin injection as a treatment for blepharospasm.

            Thirty-nine patients with blepharospasm were treated with injections of botulinum A toxin into the lid and brow. The maximum number of injections in one patient was 16 over a period of 24 months. A reduction of abnormal movement occurred in all patients, lasting up to 170 days. Both the amount and the duration of effect were dose dependent. Reinjection for recurrence had effects similar to the original injection. Tearing, dry-eye symptoms, or transient ptosis occurred in 20% of injections, especially in patients who had had previous eyelid surgery.
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              Long-term results and complications of botulinum A toxin in the treatment of blepharospasm.

              The authors review their long-term results and complications with the use of botulinum A toxin in the treatment of facial dystonias. Two hundred thirty-two patients in three diagnostic groups--essential blepharospasm, hemifacial spasm, and Meige's syndrome--were treated with botulinum A toxin. A total of 1044 treatments were given over a 4-year period. A reduction in orbicularis spasm intensity was noted in 1012 (96.9%) treatments (mean duration, 13.3 weeks). There was no clear relationship between toxin dose and the amount of spasm reduction or duration of response, and average duration of beneficial effect remained constant from the first through the twelfth injections. Complications occurred in 236 (22.6%) treatments. In most cases, these were local and transient. Symptomatic dry eye was the most common side effect, noted in 7.5% of cases. Ptosis was reported in 7.3% of treatments and photophobia in 2.5%. Diplopia involving the inferior oblique or lateral rectus muscles was seen in less than 1% of cases. There were no differences in degree of response or in complications among the three diagnostic groups, although there was a slight difference in duration of effect. Patients who had undergone previous eyelid surgery for blepharospasm did not respond differently from those without prior surgery.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                February 1998
                : 61
                : 1
                : 54-60
                Affiliations
                [1] orgnameUniversidade Federal de São Paulo orgdiv1Escola Paulista de Medicina orgdiv2Secção de Cirurgia Plástica Ocular Brazil
                [3] São Paulo orgnameSanta Casa de Misericórdia de São Paulo orgdiv1Departamento de Oftalmologia Brazil
                [2] orgname Brazil
                Article
                S0004-27491998000100054
                10.5935/0004-2749.19980098
                804ad1d2-c528-405a-89ed-df9c14f7b2eb

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 7
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                SciELO Brazil


                Botulinum A toxin,Espasmo facial unilateral,Toxina botulínica tipo A,Hemifacial spasm

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