应用A型肉毒毒素治疗面肌痉挛

目的：应用国产A型肉毒毒素治疗面肌痉挛55例并观察其远期疗效、并发症,提出治疗时的注意事项。方法：根据注射的肌肉大小决定注射点及每点的注射剂量,肌肉震颤最明显处。每注射点的肉毒毒素注射量约在15U左右,一次注射的总量一般控制在130U。首次注射后2周后复查,若痉挛未完全控制,可追加注射1次,方法相同,但注射量应减半。结果：55例患者首次注射后完全缓解38例,占69%,部分缓解17例,占31%,对部分缓解的患者10天后追加注射1次,疗效基本满意。所有患者均未出现全身及局部副作用。结论：该注射方法简单,安全无痛苦,毒副作用小,疗效佳,应当是目前治疗面肌痉挛较好的方法,尤其适合基层单位应用推广。     

注射A型肉毒毒素治疗面肌痉挛的护理特点

面肌痉挛是指一侧面部肌肉阵发性、节律性抽搐、痉挛，是神经科较难治的一种疾病。口服药物、针灸、封闭、物理治疗、红外线、射频消融等治疗均难取得良好效果。手术治疗创伤明显。笔者采用A型肉毒毒素（BTXA）局部注射治疗，临床效果较显著。现将其治疗方法及护理措施报告如下。     

A型肉毒杆菌毒素局部注射治疗眼睑及面肌痉挛的护理

眼睑及面肌痉挛是一局部肌张力障碍性常见病。多年来，常用药物、封闭、针灸、埋线、手术等疗法，效果不理想。1973年Scott[1]用A型肉毒杆菌毒素注射治疗斜视，取得成功。我科1994年2月至1995年9月，采用A型肉毒杆菌毒素（BTX-A）局部注射治疗42例，效果满意。1临床资料42例中男14例、女28例，年龄8～78岁，平均46岁。眼睑痉挛9例（双眼睑特发性不自主抽动7例，单侧上或下眼睑不自主抽动2例），面肌痉挛33例（左侧23例，右侧8例，双侧2例），表现为眼睑及面部发作性不自主抽动。病程2个月至16年，平均4年6个月。按眼睑及面肌痉挛强度分级…     

肉毒毒素治疗眼睑及面肌痉挛的疗效观察

眼睑痉挛是指眼轮匝肌的痉挛性收缩,是一种不随意的不断重复的闭眼,甚至睁眼困难,部分患者伴有面部肌痉挛,口角抽搐,影响正常生活。口服药物及封闭等方法疗效不理想。我院于2006年开始应用A型肉毒毒素治疗眼睑和面肌痉挛,取得了满意的效果,现报道如下。1材料和方法1.1临床资料:本组病例440例(男116例,女324例),年龄45～71岁,病程3个月～7年,均为门诊就诊患者。其中双侧眼睑痉挛291例,单侧眼睑痉挛23例,面肌痉挛126例。多数曾封闭(利多     

A型肉毒毒素治疗面肌痉挛53例临床观察

目的：研究分析A型肉毒毒素对面肌痉挛的临床治疗安全性和可行性,分析长期重复治疗面肌痉挛是否可行。方法：选择2009年9月～2012年5月我院收治的面肌痉挛患者53例为临床研究对象,其中首次治疗患者28例,重复治疗患者25例,对两组患者进行跟踪随访。观察比较两组患者疗效、疗效持续时间及不良反应。结果：重复治疗组患者的总有效率为100％,疗效持续时间为（4．98±1．05）月,患者发生不良反应6例,与首次治疗组患者的治疗效果无明显变化,组间比较,P〉0．05,差异无统计学意义。结论：使用A型肉毒毒素对面积痉挛进行治疗可以进行重复治疗,不会影响患者的治疗效果,且不会增加不良反应的发生,安全性较高。     

A型肉毒毒素治疗眼睑及面肌痉挛体会

自2003年8月至2004年8月，我们应用A型肉毒毒素治疗眼睑及面肌痉挛10例，均获得良好的疗效，现体会如下。     

A型肉毒毒素治疗眼睑及面肌痉挛体会

眼睑肌及面肌痉挛是一种以主动肌和拮抗肌不协调而产生阵发性或持续性收缩导致的运动障碍性疾患。长时期眼轮匝肌的非节律性的强直性收缩可导致眼轮匝肌肥大,提上睑肌腱膜炎、上睑下垂、睑外翻、倒睫、角膜炎等。严重者影响容貌及健康。笔者自2005年7月-2008年11月,应用A型肉毒毒素治疗眼睑及面肌痉挛42例均获得较好疗效,现将临床应用体会总结如下。     

A型肉毒毒素在偏侧面肌痉挛治疗中的临床体会

目的 探讨A型肉毒毒素在偏侧面肌痉挛治疗中的临床体会。方法 回顾性分析2016年6月至2020年8月间采用A型肉毒毒素治疗的12例偏侧面肌痉挛患者的病例资料。对每位入组患者应用的A型肉毒毒素剂量、注射方式、治疗效果和并发症进行汇总分析。结果 入组患者局部注射A型肉毒毒素后,患侧面肌痉挛症状得到明显控制。其中4例患者在随访期内无复发,6例患者予以追加注射1次,2例程度较重的患者,进行了2次追加注射,患侧面肌痉挛得到良好控制,随访期内未再复发。入组患者均未出现不良反应。结论 A型肉毒毒素注射可以很好地控制面肌痉挛发作,具有治疗简便、痛苦小、起效快等优点。其具体注射剂量和位点选择需依据患者性别、面肌痉挛程度等因素综合评估后进行相应调整。     

Atypical Hemifacial Spasm

Summary  Among 155 cases of hemifacial spasm (HFS), the authors found two cases of atypical HFS (1.3%) in which spasm started with the orbicularis oris and buccinator muscles, and gradually spread upward to involve the orbicularis occuli muscle, whereas the reverse process is usually seen in cases of typical HFS. The compression site in cases of atypical HFS is the posterior/rostral aspect of the facial nerve (FN), whereas it was the anterior/caudal aspect of the FN in all cases of typical HFS except for one. The meatal loop of the anterior inferior cerebellar artery (AICA) compressed the FN when the vessel passed between the FN and the eighth cranial nerve (8th N). These findings suggest that the topographical organization in the FN in the cerebellopontine cistern may be reversed to a peripheral distribution: the fibres on the posterior/rostral side of the FN innervate the lower part of the facial muscles, and those in the anterior/caudal side of the nerve innervate the upper part of the facial muscles. When examining patients with HFS, we must very carefully determine whether patients have typical or atypical HFS, to determine whether blood vessels (usually the meatal loop of the AICA) between the FN and the 8th N as well as at the root exit zone of the FN are to be decompressed.     

肉毒毒素治疗难治性玫瑰痤疮研究进展

本文总结了难治性玫瑰痤疮的临床表现及治疗难点,分析了肉毒毒素对人体的相关作用机制,并将肉毒毒素与难治性玫瑰痤疮的治疗机制相结合,总结两者之间的联系,综述了肉毒毒素治疗难治性玫瑰痤疮的相关研究进展,就近年来肉毒毒素治疗玫瑰痤疮的方法、疗效及安全性进行评估,希望对提高难治性玫瑰痤疮的疗效提供参考和帮助。     

微血管减压术治疗面肌痉挛术后并发症分析

目的探讨微血管减压术（microvascular decompression,MVD）治疗面肌痉挛术后并发症原因及处理。方法对2000年12月～2007年3月我院207例面肌痉挛行MVD术后进行1年以上的随访,观察相关并发症的发生及恢复情况。结果无一例死亡,15例（7.2%）在术后1周内出现脑脊液漏皮下积液,给予加压包扎（13例）,穿刺抽吸后加压包扎并头高脚低位（2例）处理后出院时积液基本消失,48例（23.2%）出现面瘫,20例（9.7%）出现听力下降,12例（5.8%）出现耳鸣。术后随访1～7.3年,（4.2±2.7）年,无一例发生脑脊液漏及颅内感染,面瘫及耳鸣患者全部恢复,10例（4.8%）仍有听力障碍,其中6例（2.9%）为耳聋。结论脑脊液漏、皮下积液、面瘫、耳鸣、听力下降是MVD的主要并发症,脑脊液漏、皮下积液、面瘫、耳鸣可逆转,听力障碍是远期主要的并发症,术中注重操作技巧可减少并发症的发生。     

A型肉毒毒素治疗化脓性汗腺炎的研究进展

化脓性汗腺炎是一种病变首发于毛囊的慢性化脓性炎症,以反复发作的痛性结节、脓肿、窦道、瘢痕形成为主要特点.其发病机制与遗传、免疫、感染、内分泌、吸烟、肥胖等多种因素有关.以往,化脓性汗腺炎的治疗包括抗生素治疗、手术治疗、放射治疗、激光治疗等,但效果都不尽理想.近年来,相关报道显示A型肉毒毒素注射治疗化脓性汗腺炎具有较好的...     

The Treatment of Chronic Anal Fissure with Botulinum Toxin

Background /Aims: The aim of this study was to evaluate the effectiveness of botulinum toxin for the treatment of uncomplicated dorsal chronic idiopathic anal fissure.

Material and Methods: Forty-five patients who reported post defecatory anal pain since two months or more were given a total of 20U botulinum toxin in the anal sphincter apparatus on both sides as well as below the anal fissure. Results: Thirty-seven patients received a second session of 25U botulinum toxin injection. Thirty-five patients (78%) presented completely healed anal fissure, while ten needed lateral internal sphincterotomy. All patients were followed up for 8-36 months. Two patients relapsed.

Conclusion: Local injection of botulinum toxin is a new and safe treatment; however, two sessions of injections are necessary to be effective and long-term follow-up to assess the recurrence rate of fissure is needed to evaluate further this method of treatment. Partial internal lateral sphincterotomy is no more the treatment of choice for chronic anal fissure.     

Treatment of Axillary and Palmar Hyperhidrosis with Botulinum Toxin

The author presents his experience with hyperhidrosis treatment using type-A botulinum toxin. The drug was applied on axillary, palmar, plantar, facial, inguinal, and gluteus areas for a 36-month period. The effect achieved—sweating decrease—was observed in 100% of the patients for a variable period ranging from 5 to 14 months. There was a slight decrease in hand muscle strength in some cases, which was spontaneously recovered after 2 weeks.     

A型肉毒毒素在治疗咬肌肥大中的作用

目的 评价A型肉毒毒素在治疗咬肌肥大中的作用。方法 2005年8月至2014年1月,对15例咬肌肥大患者行A型肉毒毒素治疗,并应用B型超声于术前和术后4、12、24周测量咬肌厚度。结果 本组患者术后随访6个月,咬肌注射A型肉毒毒素后4、12、24周,咬肌厚度萎缩(15.60±4.96)%、(27.72±9.13)%和(24.32±8.86)%。结论 A型肉毒毒素能有效减少咬肌厚度;B型超声测量能有效地反映咬肌萎缩的程度。     

Botulinum Toxin: An Effective Treatment for Flushing and Persistent Erythema in Rosacea

Botulinum toxin has been used to treat persistent erythema and flushing in rosacea for several years. Here, we describe two women and one man, each with rosacea with flushing and permanent erythema refractory to conventional treatment, who achieved satisfactory and lasting results following intradermal application of botulinum toxin. Two different botulinum toxin types were used. Toxin concentrations of 3.75U per 0.1 mL (abobotulinum) and 1.25U per 0.1 mL (incobotulinum) were used for each patient were used for each patient. The outcomes were measured using polarized photography to evaluate the decrease in vascular involvement. In the three cases presented here, botulinum toxin was effective for controlling erythema and flushing associated with rosacea; we also observed a prolonged duration of these improvements without the rebound effect of topical therapies.