A型肉毒毒素治疗面肌痉挛的疗效

Therapeutic Effects of Botulinum Toxin A on Facial Spasm

目的 :观察A型肉毒毒素 (BTXA)治疗面肌痉挛的疗效。方法 :面肌痉挛患者 85例 ,既往均经药物、针灸、理疗、神经干阻滞等治疗无效。使用A型肉毒毒素 ,根据痉挛肌肉 ,于眼轮匝肌及面肌多点注射 ,每一注射点注射 2 .5U ,每次注射总剂量不应超过 5 5U。结果 :完全缓解者 92 .9% (79/ 85 ) ;明显缓解者 7.1% (6 / 85 ) ;总有效率 10 0 %。平均起效时间 (3.1±1.6 )d。平均疗效维持时间 (2 3.4± 2 .6 )周。未见全身副作用 ,局部副作用主要表现为闭目力弱 9例 ,眼睑下垂 5例 ,面肌无力 6例 ,均于 1月内自行缓解。结论 :A型肉毒毒素治疗面肌痉挛疗效显著 ,为一种简便、安全的方法。

Objective: to observe the effect of botulinum toxin A (BTXA) on facial spasm. Method: 85 patients with facial spasm did not respond to drug therapy, acupuncture, physiotherapy, neurotrunk blockage treatment etc. In our treatment, BTXA was used for local injection into orbicularis oculi and facial muscles at several points for a dosage of 2.5 U each point, with a total dose not exceeding 55 U. Results: 92.9% (79/85) of the patients were completely relieved, 7.1% (6/85) remarkably improved, with an overall effective rate as high as 100%. Therapeutic effects occurred within 1～7 days after injection and average response time was ( 3.1 ±1.6) days. Therapeutic effectiveness lasted for 18～32 weeks, and average duration was (23.4±2.6) weeks. Generally, treatment did not show any serious side effects, but with mild local side effects including eye closure weakness (9 cases), ptosis (5 cases) and facial muscles weakness (6 cases), that all recovered spontaneously within a month. Conclusion: BTXA is an agent effective for the treatment of facial spasm and has features of simple and safe applications.