A型肉毒毒素（BTX—A）治疗眼睑痉挛、面肌痉挛（附78例次分析）

目的　观察 A型肉毒毒素局部注射对眼睑痉挛、面肌痉挛的治疗作用。方法　对眼睑痉挛、面肌痉挛患者按病情程度进行分级 ,予 A型肉毒毒素局部注射 ,定期评价其分级程度。结果　眼睑痉挛有效率 92 .6 % ,作用时间 15 .11± 4 .94周 ;面肌痉挛有效率 10 0 % ,作用时间 17.72± 4 .2 3周。可重复注射 ,副作用轻微、短暂 ,无全身、过敏反应。结论　 A型肉毒毒素安全、有效 ,是治疗眼睑痉挛、面肌痉挛的首选方法     

A型肉毒毒素治疗面肌痉挛及眼睑痉挛82例临床分析

目的观察A型肉毒毒素（BTXA）治疗偏侧面肌痉挛及眼睑痉挛的疗效。方法用A型肉毒毒素对70例偏侧面肌痉挛及12例眼睑痉挛患者行面部肌肉局部多点注射,分析其治疗效果。结果 70例偏侧面肌痉挛者,完全缓解25例（35.7%）,明显缓解45例（64.3%）;12例眼睑痉挛患者,完全缓解4例（33.3%）,明显缓解7例（58.3%）,无效1例（8.4%）。结论 A型肉毒毒素局部肌肉注射可有效控制局部肌张力过高,缓解局部肌肉痉挛,是简便、安全的治疗方法 。     

局部注射A型肉毒毒素治疗偏侧面肌痉挛及眼睑痉挛44例

目的:观察A型肉毒毒素治疗偏侧面肌痉挛及眼睑痉挛的疗效。方法:用A型肉毒毒素对38例偏侧面肌痉挛及6例眼睑痉挛患者行面部肌肉局部多点注射,分析其治疗效果。结果:38例偏侧面肌痉挛者,完全缓解12例(32%),明显缓解26例(68%);6例眼睑痉挛患者,2例完全缓解,3例明显缓解,1例无效。结论:A型肉毒毒素局部肌肉注射可有效控制局部肌张力过高,缓解局部肌肉痉挛。     

A型肉毒毒素治疗面肌、眼睑痉挛及Meige综合症临床观察

目的探讨A型肉毒毒素治疗面肌、眼睑痉挛及Meige综合症的疗效。方法采用A型肉毒毒素局部注射偏侧面肌痉挛102例,眼睑痉挛41例及Meige综合症13例,并使用Cohen和Albert量表进行评估。结果症状完全缓解占51.3%,明显改善占37.8%,部分改善占10.9%,疗效平均持续约3～6月,复发者重复注射仍有效,出现眼睑闭合不全、面肌无力、眼睑下垂共58例,均恢复。结论局部注射A型肉毒毒素确为一种安全有效、简便易行的治疗面肌、眼睑痉挛及Meige综合症的手段。     

A型肉毒毒素注射治疗眼睑和面肌痉挛52例临床观察

目的:观察A型肉毒毒素注射治疗眼睑、面肌痉挛的疗效及不良反应。方法:采用A型肉毒毒素局部注射治疗眼睑痉挛、面肌痉挛52例(73例次),使用痉挛强度分级量表进行病情评估。结果:患者中98%症状明显改善,疗效持续8～30周,可在3～6个月后重复注射仍有疗效。未发现有全身反应,不良反应轻微,所有局部并发症均在数周内恢复正常。结论:局部注射A型肉毒毒素治疗眼睑痉挛、面肌痉挛安全有效。     

A型肉毒毒素治疗面肌、眼睑痉挛及Meige综合症临床观察

目的 探讨A型肉毒毒素治疗面肌、眼睑痉挛及Meige综合症的疗效。方法 采用A型肉毒毒素局部注射偏侧面肌痉挛102例，眼睑痉挛41例及Meige综合症13例，并使用Cohen和Albert量表进行评估。结果 症状完全缓解占51．3％，明显改善占37．8％，部分改善占10．9％，疗效平均持续约3～6月，复发重复注射仍有效，出现眼睑闭合不全、面肌无力、眼睑下垂共58例，均恢复。结论 局部注射A型肉毒毒素确为一种安全有效、简便易行的治疗面肌、眼睑痉挛及Meige综合症的手段。     

局部注射A型肉毒杆菌毒素治疗面肌痉挛的效果

目的观察肉毒毒素局部注射治疗面肌痉挛的临床疗效、作用时间及不良反应。方法采用A型肉毒毒素对56例面肌抽搐患者进行多点肌肉注射,观察治疗前后效果、作用维持时间和并发症。结果治疗面肌痉挛56例(96例次),完全缓解34例(61．71％),明显缓解21例(37．5％),无效1例(1．7％);总有效率98．2％。注射后起效时间4h至8d,平均(2．4±1．6)d,药物作用时间2-8个月,平均(4±1．3)个月。未见过敏反应,不良反应轻微、可逆。结论A型肉毒毒素局部肌肉注射是一种简捷、有效、安全的治疗面肌痉挛的方法。     

A型肉毒毒素治疗面肌痉挛15例

目的 :观察A型肉毒毒素治疗面肌痉挛疗效。方法 :根据痉挛肌肉的情况 ,在眼轮匝肌及面肌多点注射 ,眼轮匝肌采用皮下注射 ,面肌以肌肉注射 ,每一点注射A型肉毒毒素 0 .1ml(含 2 .5U)。结果 :眼睑痉挛者显效率 83 .3 % ,面肌痉挛者显效率 66.6% ,总显效率 73 .3 %。结论 :A型肉毒毒素治疗面肌痉挛疗效较好 ,复发病例不必增大剂量已能达到满意疗效     

A型肉毒毒素注射治疗面肌痉挛临床疗效观察

目的观察A型肉毒毒素注射治疗面肌痉挛的疗效及副反应情况。方法采用A型肉毒毒素局部注射治疗面肌痉挛32例（122例次）,使用Cohen和Albert量表进行评估。结果症状完全缓解占50%,明显缓解31.25%,部分缓解18.75%,所有病人均有疗效,疗效平均持续3-6个月,复发者重复注射仍有效,副作用轻微。结论局部注射A型肉毒毒素治疗面肌痉挛安全有效。     

小剂量A型肉毒毒素治疗面肌痉挛

目的 :探讨小剂量 (2 .0U )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 :面肌痉挛病人 5 8例 (男性 2 4例 ,女性 34例 ;年龄 4 7a±s 13a)采用A型肉毒毒素 (2 .0U )局部多点注射痉挛肌肉 ,治疗前后对照。结果 :治疗面肌痉挛 5 8例 ,有效率 97% (5 6 /5 8) ,作用持续 15wk± 4wk。副作用轻微、可逆。结论 :小剂量A型肉毒毒素治疗面肌痉挛疗效肯定 ,副作用少     

A型肉毒毒素治疗睑痉挛的临床研究

目的　观察A型肉毒毒素对睑痉挛的治疗效果。方法　对 2 0例特发性眼睑痉挛和 2 4例Meige综合征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　 1～ 3d出现症状缓解 ,1周症状明显缓解 ,有效率达 10 0 %。特发性眼睑痉挛有效作用时间为 12～ 32周 (平均 17 4周 ) ,Meige综合征有效作用时间为10～ 2 0周 (平均 13 2周 )。结论　A型肉毒毒素局部肌肉注射治疗睑痉挛是一种安全、有效、简便、易行的方法。     

A型肉毒毒素治疗肌张力过强

目的：探讨Ａ型肉毒毒素局部注射治疗面肌痉挛、各型头颈肌张力障碍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痉挛肌肉,治疗前后对照。结果：治疗面肌痉挛２５０例（１０２８轮次）,有效率１００％,作用持续１６ｗｋ±ｓ４ｗｋ;睑痉挛７８例（２６０轮次）,有效率９３．９％,作用持续１５ｗｋ±４ｗｋ;口颌肌痉挛５３例（１８１轮次）,有效率８５．１％,作用持续１４ｗｋ±４ｗｋ;痉挛性斜颈２８例（７９轮次）,有效率８１％,作用持续１４ｗｋ±４ｗｋ。副作用轻微、可逆。结论：该疗法安全、有效,可作为面肌痉挛及各型头颈部肌张力障碍的首选治疗。     

原发性偏侧面肌痉挛与Meige综合征及A型肉毒素对其治疗的研究现状

对国内外关于原发性偏侧面肌痉挛及Meige综合征和A型肉毒素对其治疗的文献进行回顾性分析,阐述原发性偏侧面肌痉挛及Meige综合征的发病机制、诊断及治疗现状,重点阐述A型肉毒毒素注射治疗原发性偏侧面肌痉挛及Meige综合征的适应证、药物使用浓度、药效、药效持续时间、注射位点、并发症及对情绪的影响等。明确A型肉毒毒素治疗原发性偏侧面肌痉挛及Meige综合征的优越性。     

Safety, effectiveness, and duration of effect of BOTOX after switching from Dysport for blepharospasm, cervical dystonia, and hemifacial spasm dystonia, and hemifacial spasm

BACKGROUND: Local injection of botulinum toxin type A is first-line treatment of blepharospasm, cervical dystonia, and hemifacial spasm; however, there is uncertainty about the optimal dose of toxin for each indication as well as dose-conversion ratios that should be used when switching products in clinical practice. OBJECTIVE: The goal of this study was to compare the safety, effectiveness, and duration of clinical effect of BOTOX and Dysport and Dysportdagger after drug switching (Dysport to BOTOX) among patients with movement disorders. METHODS: A total of 48 patients diagnosed with blepharospasm (n = 27), cervical dystonia (n = 12), or hemifacial spasm (n = 9) were evaluated during a single-arm, crossover-design study in which each patient was his/her own historical control using a 5:1 or 4:1 conversion ratio of Dysport to BOTOX units. Patients were assessed (using Jankovic, Visual Analog Scale, general pain scale, Toronto Western Spasmodic Torticollis Rating Scale [TWSTRS] scores) after the last injection of Dysport and the first injection of BOTOX. Moreover, each patient kept a diary during treatment to track onset and duration of therapeutic effect. RESULTS: Although BOTOX and Dysport were both clinically effective, this effect was more significant with BOTOX compared to Dysport based on TWSTRS for cervical dystonia (p = 0.012), and Jankovic scores for blepharospasm (p = 0.006). Longer duration of effect also was noted with BOTOX than with Dysport (blepharospasm, 62.2 days vs 47.4 days (p = 0.001); cervical dystonia, 64.3 days vs 44.6 days (p = 0.014); hemifacial spasm, 65.1 days vs 41.8 days (p < 0.014), respectively). Of the 48 patients, 19 experienced at least one adverse drug reaction (ADR) during Dysport treatment, with the most commonly reported ADRs being ptosis for blepharospasm and hemifacial spasm and neck weakness for cervical dystonia. No patient reported an ADR during BOTOX treatment. CONCLUSIONS: Results suggest therapeutic effectiveness is enhanced with BOTOX compared to Dysport at a dosing ratio between 5:1 and 4:1 (Dysport:BOTOX). Safety and duration of therapeutic effect also are enhanced with BOTOX. Further research is needed.     

Type A botulinum toxin: a new treatment for axillary and palmar hyperhidrosis

Hyperhidrosis is an invalidating condition, and one that is difficult to treat. It is characterized by an excessive and uncontrolled production of sweat by the sweat glands, often causing psychological, social, and occupational problems for the patient. Hyperhidrosis can be distinguished in two forms: idiopathic (of unknown etiology), or secondary, due to an alteration of the endocrine system (ex: hyperthyroidism, neuropathy, neoplasia etc.) It is found in about 0.3-0.5% of the population and can be localized (axillary, palmar, plantar, facial) or diffused. The subcutaneous injection of type A botulinum toxin, until now used only for the treatment of blepharospasm or hemifacial spasm, has shown to be a useful treatment for localized hyperhidrosis. The objective of the authors is to evaluate the therapeutic efficacy, safety, and management of botulinum toxin treatment in patients affected with axillary or palmar hyperhidrosis resistant to conventional therapies.     

A型肉毒毒素治疗紧张型头痛合并面肌痉挛的疗效观察

目的观察紧张型头痛合并面肌痉挛患者选择A型肉毒毒素治疗的临床效果。方法 52例紧张型头痛合并面肌痉挛患者,采用随机单盲法分为对照组和观察组,每组26例。对照组患者采用常规治疗,观察组患者采用A型肉毒毒素治疗。比较两组患者治疗效果、不良反应发生情况及疼痛评分。结果观察组患者的治疗总有效率100.00%明显高于对照组的80.77%,差异有统计学意义(P<0.05)。观察组不良反应发生率11.54%(3/26)和对照组的7.69%(2/26)比较差异无统计学意义(χ²=0.221, P=0.638>0.05)。治疗后,观察组患者的疼痛评分(4.1±0.6)分低于对照组的(4.9±0.9)分,差异具有统计学意义(t=3.771, P=0.000<0.05)。结论 A型肉毒毒素治疗紧张型头痛合并面肌痉挛的效果显著,安全度高,能减轻疼痛感受程度,应在临床治疗中引起关注。     

Safety,effectiveness, and duration of effect of BOTOX after switching from Dysport for blepharospasm,cervical dystonia,and hemifacial spasm

ABSTRACT

Background: Local injection of botulinum toxin type A is first-line treatment of blepharospasm, cervical dystonia, and hemifacial spasm; however, there is uncertainty about the optimal dose of toxin for each indication as well as dose-conversion ratios that should be used when switching products in clinical practice.

Objective: The goal of this study was to compare the safety, effectiveness, and duration of clinical effect of BOTOX and Dysport after drug switching (Dysport to BOTOX) among patients with movement disorders.

Methods: A total of 48 patients diagnosed with blepharospasm (n = 27), cervical dystonia (n = 12), or hemifacial spasm (n = 9) were evaluated during a single-arm, crossover-design study in which each patient was his/her own historical control using a 5:1 or 4:1 conversion ratio of Dysport to BOTOX units. Patients were assessed (using Jankovic, Visual Analog Scale, general pain scale, Toronto Western Spasmodic Torticollis Rating Scale [TWSTRS] scores) after the last injection of Dysport and the first injection of BOTOX. Moreover, each patient kept a diary during treatment to track onset and duration of therapeutic effect.

Results: Although BOTOX and Dysport were both clinically effective, this effect was more significant with BOTOX compared to Dysport based on TWSTRS for cervical dystonia (?p = 0.012), and Jankovic scores for blepharospasm (?p = 0.006). Longer duration of effect also was noted with BOTOX than with Dysport (blepharospasm, 62.2?days vs 47.4?days (?p = 0.001); cervical dystonia, 64.3?days vs 44.6?days (?p = 0.014); hemifacial spasm, 65.1?days vs 41.8?days (?p < 0.014), respectively). Of the 48 patients, 19 experienced at least one adverse drug reaction (ADR) during Dysport treatment, with the most commonly reported ADRs being ptosis for blepharospasm and hemifacial spasm and neck weakness for cervical dystonia. No patient reported an ADR during BOTOX treatment.

Conclusions: Results suggest therapeutic effectiveness is enhanced with BOTOX compared to Dysport at a dosing ratio between 5:1 and 4:1 (Dysport:BOTOX). Safety and duration of therapeutic effect also are enhanced with BOTOX. Further research is needed.     

A型肉毒毒素治疗局限性肌张力障碍的临床研究

目的 探讨A型肉毒毒素(BTX—A)局部注射治疗局限性肌张力不全(偏侧面肌痉挛、眼睑痉挛、Meige综合症)的临床疗效及安全性。方法：对186例病人采用BTX—A局部多点注射痉挛肌肉，并进行治疗前后的病情分级及疗效对比。结果：治疗后随访至少半年，BTX—A治疗有效率为100％，疗效持续8W～28W，最好疗效维持2月左右。复发者重复注射治疗同样有效。注射后病人可出现轻度的局部肌无力，如眼睑闭合不良、轻度面瘫。但均在短期内恢复，副作用轻微可逆。结论：BTX—A治疗方法简单、安全、有效，可作为头面部肌张力障碍的首选治疗。