A型肉毒毒素治疗眼睑及面肌痉挛30例分析

目的：肉毒毒素治疗眼睑、面肌痉挛的临床应用。方法：应用肉毒毒素对眼睑、面肌痉挛患者30例进行局部多点注射法。结果：30例眼睑、面肌痉挛经注射肉毒毒素，大部分完全缓解，少部分经二次注射也明显缓解，有效率达100％，全部病例均未出现全身局部并发症。结论：肉毒毒素局部注射是眼睑、面肌痉挛患者一种安全有效的治疗方法，值得临床推广。     

A型肉毒毒素局部注射治疗面肌痉挛58例分析

目的观察A型肉毒毒素注射治疗面肌痉挛的疗效及不良反应情况。方法采用A型肉毒毒素局部注射治疗面肌痉挛58例,使用Cohen评分进行评估。结果完全缓解50例,明显缓解7例,部分缓解1例,首次注射后有效率95.5%,所有患者均有疗效,疗效持续7~18周,复发者重复注射仍有效,不良反应轻微。结论局部注射A型肉毒毒素治疗面肌痉挛安全有效。     

A型肉毒毒素治疗面肌痉挛的临床研究

目的 探讨A型肉毒毒素治疗面肌痉挛的疗效。方法 对116例面肌痉挛进行面部肌肉局部多点注射A型肉毒毒素，评价其治疗效果。结果 116例面肌痉挛患者，总有效率为98．3％，1年后复发率为85．1％，重复注射后仍有良效。主要的并发症是轻微周围性面瘫和眼睑下垂，无过敏及全身毒副作用。结论 A型肉毒毒素局部肌肉注射是治疗面肌痉挛安全有效、简便易行的方法。     

A型肉毒毒素注射治疗眼睑及面肌痉挛的效果与护理

目的探讨小剂量A型肉毒毒素多点注射治疗眼睑及面肌痉挛的临床疗效、安全性及护理方法。方法105例眼睑及面肌痉挛患者,给予小剂量A型肉毒毒素多点注射治疗,进行复诊或电话随访,记录复诊、电话随访的临床指标,并给予心理护理、注射护理和健康教育。结果经过电话随访或复诊,105例患者均在1～3d内显效,平均（1．1±0．5）d;完全缓解64例（60．95％）,明显缓解28例（26．67％）,部分缓解6例（5．71％）。无全身中毒及过敏反应,局部不良反应轻微、短暂。结论小剂量A型肉毒毒素多点注射治疗眼睑及面肌痉挛的临床疗效确切,安全性较高,针对患者给予细心周到的护理,对患者康复、减轻其身心痛苦具有重要意义。     

A型肉毒毒素治疗面肌痉挛的临床研究

目的 探讨A型肉毒毒素局部注射治疗面肌痉挛的临床疗效和安全性.方法 采用A型肉毒毒素局部多点注射面部痉挛肌肉,治疗前后进行疗效对照.结果 治疗面肌痉挛30例,有效率为100％,作用持续(20±4)周,不良反应轻微、可逆.结论 A型肉毒毒素治疗面肌痉挛安全、有效,可作为面肌痉挛的首选治疗.     

A型肉毒毒素注射治疗面肌痉挛的护理

目的:探讨A型肉毒毒素注射治疗面肌痉挛的护理.方法:对我院122例面肌痉挛患者进行A型肉毒毒素注射治疗的临床护理资料进行回顾性分析.结果:122例面肌痉挛患者经A型肉毒毒素注射治疗,配合适时临床护理,治疗后均获得良好效果,无严重并发症.结论:对患者规范细致周到的护理有助于提高肉毒毒素注射疗效,减少并发症.     

眼科患者对A型肉毒毒素注射认知情况调查及护理对策

目的：了解眼科患者对A型肉毒毒素眼部注射的认知情况,探讨更有利于患者需求的护理对策。方法：2011年8月-2012年1月,采用白行设计调查问卷,对i00例在我院眼科门诊接受A型肉毒毒素眼部注射的患者进行调查。结果：70％的患者对A型肉毒毒索治疗眼睑及面肌痉挛相关知识为部分了解;82％的患者表示非常希望了解关于A型肉毒毒索眼部注射的相关医学及护理知识。患者不能坚持治疗的主要原因是担忧A型肉毒毒素眼部注射后出现的副作用。结论：眼科患者对A型肉毒毒素眼部注射认知情况较低,我们应将护理工作的重点放在让患者知晓A型肉毒毒素治疗眼睑及面肌痉挛的目的、方法,让其充分了解眼部注射后的局部表现,掌握注射部位的护理方法。满足患者对医护人员健康宣教的需求。     

A型肉毒毒素治疗头颈部肌张力障碍100例

目的观察A型肉毒毒素治疗面肌抽搐、眼睑痉挛及痉挛性斜颈的疗效。方法采用国产A型肉毒毒素局部注射治疗100例头颈部局限性肌张力障碍患者,应用肌电图确定注射肌肉及用同轴电极针局部注射A型肉毒毒素治疗8例痉挛性斜颈,分析其治疗效果与剂量、注射位点的关系。结果采用Co-hen等分级标准,76例偏侧面肌痉挛者,完全缓解15例,明显缓解57例;16例眼睑痉挛者,完全缓解7例,明显缓解9例;采用Tsui等评分标准,8例痉挛性斜颈者明显缓解;总有效率100%。治疗后眼睑及面肌抽搐明显减轻或消失,患者满意率100%。偏侧面肌痉挛及眼睑痉挛起效时间8～48h,使用剂量20～40U,最佳使用剂量30～35U;痉挛性斜颈起效时间7～10d。副反应轻微、短暂,无全身反应及过敏反应。结论A型肉毒毒素局部肌肉注射是治疗局限性肌张力障碍病的首选方法。主张多位点、小剂量注射,肌电图定位引导注射A型肉毒毒素对痉挛性斜颈者可减少药物使用剂量,提高疗效。     

国产A型肉毒毒素治疗眼睑及面肌痉挛疗效评价

目的评价国产A型肉毒毒素局部注射法治疗眼睑痉挛及面肌痉挛的效果。方法120例眼睑痉挛患者，92例面肌痉挛患者，根据病情选择注射点局部注射A型肉毒毒素，2～6个月后观察痉挛缓解症状。结果完全缓解者140例，占66％；明显缓解62例，占29．2％；部分缓解10例，占4．8％；总有效率100％。疗效维持时间为2～6个月，绝大部分病人维持3-4个月，个别病例观察半年仍未复发。治疗后复发者156例，再次重复注射痉挛又获得缓解，维持时间与初次治疗大致相同。结论应用国产A型肉毒毒素治疗眼睑痉挛及面肌痉挛安全有效，是目前治疗肌张力障碍性疾病较为理想的治疗方法，又因其操作简单，不需特殊设备，值得在基层医院推广应用。     

A型肉毒毒素治疗面肌痉挛的护理

A型肉毒毒素为厌氧梭型芽胞菌属肉毒梭菌产生的一种大分子蛋白毒素,局部注射后在肌肉弥散,其中的神经毒分子迅速与神经肌肉接头的胆碱能突触前受体结合,阻滞神经突触乙酰胆碱的释放,从而缓解肌肉痉挛.近来广泛应用于临床治疗面肌痉挛,我院神经内科自1997年始用该药治疗面肌痉挛28例,配合临床护理均取得满意疗效.     

Cognitive Performance After Facial Botulinum Toxin Treatment in a Cohort of Neurologic Patients: An Exploratory Study

ObjectiveTo investigate higher cognitive functions after mimicry changes after facial botulinum toxin (BTX) injections, we tested verbal and nonverbal reasoning in patients with blepharospasm or hemifacial spasm before and after their long-term botulinum toxin treatment.DesignExplorative, nonrandomized, clinical trial.SettingPatients receiving ambulatory care and control participants from the general community.ParticipantsVolunteer sample (N=84) of patients (n=21) with blepharospasm or hemifacial spasm who received facial BTX injections. Control participants included patients (n=30) with cervical dystonia who received cervical BTX injections and individuals without neurological disorders (n=33).InterventionsThe 2 groups receiving injections were tested before and 3 weeks after their treatment. The group without neurological disorders received no injections.Main Outcome MeasuresVerbal and nonverbal reasoning scores.ResultsThe key unexpected finding was that patients who received facial BTX injections perform significantly worse in nonverbal reasoning tasks, when compared with those who did not receive injections (P=.022). There was no significant difference in the baseline reasoning scores and at follow-up for verbal reasoning between the 3 groups. There was no correlation between toxin dose and reasoning scores (verbal: P=.132; nonverbal: P=.294).ConclusionsBecause of potential confounders, the results do not yet allow any conclusion on causality. Further research is needed to confirm our findings.     

Botulinum toxin therapy for neurologic disorders.

In the last 20 years, the therapeutic uses of botulinum toxin, a potent neurotoxin, have been investigated. The agent produces chemical denervation of muscle, thereby causing atrophy and weakness. Studies have shown that injection of this agent is an effective therapy for focal dystonias, particularly blepharospasm, hemifacial spasm, and torticollis. Investigation continues into the role of botulinum toxin in the treatment of anismus, detrusor-sphincter dyssynergia, writers' cramp, and other disorders in which focal weakening of selected muscles could be useful.     

Botulinum Neurotoxin for the Treatment of Migraine and Other Primary Headache Disorders: From Bench to Bedside

Botulinum toxin type A, a neurotoxin, is effective for treating a variety of disorders of involuntary muscle contraction including cervical dystonia, blepharospasm, and hemifacial spasm. It inhibits neuromuscular signaling by blocking the release of acetylcholine at the neuromuscular junction. The biological effects of the toxin are transient, with normal neuronal signaling returning within approximately 3 to 6 months postinjection.
Recent clinical findings suggest that botulinum toxin type A may inhibit pain associated with migraine and other types of headache. However, the mechanism by which this toxin inhibits pain is not fully understood and is under investigation. Research findings suggest that botulinum toxin type A inhibits the release of neurotransmitters from nociceptive nerve terminals and, in this way, may possess an analgesic effect. A number of retrospective open-label chart reviews and 3 double-blind, placebo-controlled trials have demonstrated that localized injections of botulinum toxin type A significantly reduce the frequency, severity, and disability associated with migraine headaches. Although the majority of patients in these studies experienced no botulinum toxin type A-mediated side effects, a small percentage of patients did report transient minor side effects including blepharoptosis, diplopia, and injection-site weakness. Currently, 4 randomized, placebo-controlled, clinical trials are being conducted to evaluate the efficacy, optimal dosing, and side-effect profile of botulinum toxin type A as a novel treatment for migraine and other types of headache. These studies may provide further evidence that botulinum toxin type A is an effective option for the preventive treatment of migraine.     

Botulinum neurotoxin for the treatment of migraine and other primary headache disorders: from bench to bedside

Botulinum toxin type A, a neurotoxin, is effective for treating a variety of disorders of involuntary muscle contraction including cervical dystonia, blepharospasm, and hemifacial spasm. It inhibits neuromuscular signaling by blocking the release of acetylcholine at the neuromuscular junction. The biological effects of the toxin are transient, with normal neuronal signaling returning within approximately 3 to 6 months postinjection. Recent clinical findings suggest that botulinum toxin type A may inhibit pain associated with migraine and other types of headache. However, the mechanism by which this toxin inhibits pain is not fully understood and is under investigation. Research findings suggest that botulinum toxin type A inhibits the release of neurotransmitters from nociceptive nerve terminals and, in this way, may possess an analgesic effect. A number of retrospective open-label chart reviews and 3 double-blind, placebo-controlled trials have demonstrated that localized injections of botulinum toxin type A significantly reduce the frequency, severity, and disability associated with migraine headaches. Although the majority of patients in these studies experienced no botulinum toxin type A-mediated side effects, a small percentage of patients did report transient minor side effects including blepharoptosis, diplopia, and injection-site weakness. Currently, 4 randomized, placebo-controlled, clinical trials are being conducted to evaluate the efficacy, optimal dosing, and side-effect profile of botulinum toxin type A as a novel treatment for migraine and other types of headache. These studies may provide further evidence that botulinum toxin type A is an effective option for the preventive treatment of migraine.     

Headache and Facial Pain Responsive to Botulinum Toxin: An Unusual Presentation of Blepharospasm

The diagnosis of blepharospasm is rarely considered in patients complaining of face pain or headache. This patient illustrates the importance of looking for blepharospasm in patients who present with headache or face pain, as her pain and blepharospasm were successfully treated with botulinum toxin type A injections.     

A型肉毒杆菌毒素治疗面肌痉挛235例临床研究

目的探讨A型肉毒杆菌毒素(BTXA)治疗面肌痉挛(HFS)的疗效及副作用.方法对235例HFS病人进行面肌多点注射BTXA,对治疗前后的病情分级进行比较,并随访12～36周.结果BTXA治疗的总有效率为98.3%(231/235),无全身反应,半年复发率为60%,药效作用时间平均16周;重复注射同样有效.结论局部注射BTXA是治疗HFS的一种有效手段.     

Treatment of essential blepharospasm

A rather confusing number of conservative, as well as invasive treatment methods for essential blepharospasm are found in the literature. Depending on the severity of symptoms, two types of method became important because of their obvious success and their low rate of complications: Local injection--treatment with botulinum toxin type A in mild and moderate cases and the neurosurgical method of selective neurotomy in severe forms of blepharospasm or after inefficient application of botulinum-A toxin. The different methods of treatment are reviewed.     

Treatment of blepharospasm with botulinum toxin

Many therapeutic modalities, including medications, excision of the muscles used in closure of the eyelids (myectomy), and selective extirpation of branches of the facial nerve (neurectomy), have been used for the management of blepharospasm. Because of limited effectiveness and undesirable side effects, none of these treatments has been completely satisfactory. Recent reports about injection of botulinum toxin indicate that it is safe and effective for most patients. Relief from blepharospasm, however, is usually transient, and repeated injections are usually necessary. The current availability of effective therapy for blepharospasm emphasizes the importance of prompt diagnosis and referral of affected patients to physicians knowledgeable in the use of botulinum toxin and other therapeutic approaches.     

肉毒杆菌毒素在眼科的应用进展

肉毒杆菌毒素是由肉毒杆菌在繁殖过程中所产生的一种神经毒素蛋白,其作用机制是阻断乙酰胆碱在胆碱能神经的神经肌肉接头释放而阻断传导冲动。在眼科诊疗中,它已被常规用于眼睑痉挛、斜视、眼周除皱、上睑挛缩等眼部疾病的治疗,其疗效确切。本文综述了肉毒杆菌毒素在眼科的相关应用进展。