Cakmur Raif, Ozturk Vesile, Uzunel Fatma, Donmez Beril, Idiman Fethi
Dokuz Eylül Universitesi, Tip Fakültesi, Nöroloji Klinigi, Inciralti Izmir, Turkey.
J Neurol. 2002 Jan;249(1):64-8. doi: 10.1007/pl00007849.
Although the beneficial effect of subcutaneous injections of botulinum toxin type A (BTX-A) is well known in both blepharospasm and hemifacial spasm, the position of the injection sites around the orbicularis oculi may influence the effectiveness and side effects. Here we report results of preseptal and pretarsal BTX-A injections in 53 patients (25 blepharospasm and 28 hemifacial spasm) in whom we used both injection techniques successively. Pretarsal injections were used in 102 out of 186 treatments in blepharospasm group and in 84 out of 202 treatments in hemifacial spasm group. Pretarsal BTX-A treatment produced significantly higher response rate and longer duration of maximum response in both patient groups. This technique was also associated with a lower frequency of major side effects such asptosis. We concluded that injections of BTX-A into the pretarsal, rather than the preseptal portion of the orbicularis oculiis more effective for treatment of involuntary eyelid closure due to contractions of this muscle.
尽管皮下注射A型肉毒杆菌毒素（BTX-A）在眼睑痉挛和半面痉挛中的有益效果已广为人知，但眼轮匝肌周围注射部位的位置可能会影响疗效和副作用。在此，我们报告了对53例患者（25例眼睑痉挛和28例半面痉挛）先后采用睑前和睑板前BTX-A注射技术的结果。在眼睑痉挛组的186次治疗中有102次采用睑板前注射，在半面痉挛组的202次治疗中有84次采用睑板前注射。睑板前BTX-A治疗在两组患者中均产生了显著更高的反应率和更长的最大反应持续时间。该技术还与诸如上睑下垂等主要副作用的较低发生率相关。我们得出结论，将BTX-A注射到睑板前而非睑前的眼轮匝肌部分，对于治疗因该肌肉收缩导致的不自主眼睑闭合更为有效。
