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Rehabilitation Practice and Science

Yu-Ching lLin

Translated Title

以A型肉毒桿菌毒素長期治療半面痙攣症

Abstract

Hemifacial spasm is a rare movement disorder. It is characterized by recurrent, involuntary tonic or clonic contraction of the muscles innervated by unilateral facial nerve. It may affect patient’s vision and has great cosmetic or psychological impacts. Oral drugs including anticonvulsants, baclofen and benzodiazepines often have little effect. Surgery has potentially serious complications. After numerous clinical studies, botulinum toxin is now recommended as the primary treatment of choice for most hemifacial spasm cases.The purpose of this study is to retrospectively evaluate the dose, effect and side effects of long-term treatment of hemifacial spasm with type A botulinum toxin. Between November 1999 and December 2002, 14 patients with hemifacial spasm receiving a total of 48 times of botulinum toxin injection were enrolled from outpatient PMR clinic. Type A botulinum toxin was administered intramuscularly according to the severity of symptoms and involved muscles. Patients were asked to record the onset and the duration of spasm-free period, and to report any side effect. Hemifacial spasm intensity scale was used as an assessment tool. The total injection doses varied from 15 units to 50 units. The effect of drug lasted 3 to 9 months, with an average of 5.5 months. After each injection, the majority of patients had at least two-grade improvement in spasm intensity scale. There is no serious side effect in the period of treatment and follow-up for 3 years. Every patient was satisfied with the result. Sustained effect of botulinum toxin after each injection was noted for 3 years in our cases, in accordance with western series of 7-year follow-up. This study suggested that botulinum toxin is a safe and effective treatment option in long-term management of hemifacial spasm in Taiwanese.

Language

Traditional Chinese

First Page

33

Last Page

38

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