Struys M A, Devriese P P, Ongerboer de Visser B W, Speelman J D, de Jong P T
Afd. Neurologie, Academisch Medisch Centrum, Amsterdam.
Ned Tijdschr Geneeskd. 1991 May 18;135(20):889-92.
At the Academic Medical Center of the University of Amsterdam the results of treatment of hemifacial spasms (HFS) with botulinum toxin type A were evaluated in a pilot study. Five men and 21 women with HFS were treated with toxin injections. The mean age was 65 years. Most patients were referred from other centers and had been previously treated without success with various medications or with surgical treatment. Treatment took place at the outpatient department. The toxin was injected into the M. orbicularis oculi at the medial and lateral sides of the upper and lower lids. The total dose varied between 6 and 16 LD50. Patients were reinjected on demand. All patients except for one reported satisfying improvement of their spasm. The onset of the beneficial effect was 1-2 days after the injection and the effect lasted about 3 months. All patients were re-examined 1 to 2 weeks after each treatment and showed reduction or disappearance of synkinesias. No systemic side effects occurred and local complications were mild and transient. We conclude that local injection of botulinum toxin appears to be a successful alternative in the current treatment of hemifacial spasm.
在阿姆斯特丹大学学术医疗中心，一项初步研究对A型肉毒杆菌毒素治疗半面痉挛（HFS）的效果进行了评估。5名男性和21名患有HFS的女性接受了毒素注射治疗。平均年龄为65岁。大多数患者是从其他中心转诊而来，此前曾接受过各种药物治疗或手术治疗但均未成功。治疗在门诊部进行。毒素被注射到上下眼睑内外侧的眼轮匝肌中。总剂量在6至16个半数致死量（LD50）之间。患者根据需要进行再次注射。除一名患者外，所有患者均报告痉挛症状得到了令人满意的改善。有益效果在注射后1至2天出现，效果持续约3个月。每次治疗后1至2周对所有患者进行复查，结果显示联带运动减少或消失。未出现全身性副作用，局部并发症轻微且为一过性。我们得出结论，局部注射肉毒杆菌毒素似乎是目前治疗半面痉挛的一种成功替代方法。
