Streitová Hana, Bareš Martin
First Department of Neurology, Medical Faculty, St. Anne's Hospital, Masaryk University, Pekařská 53, 656 91, Brno, Czech Republic.
Acta Neurol Belg. 2014 Dec;114(4):285-91. doi: 10.1007/s13760-014-0285-z. Epub 2014 Mar 7.
Botulinum toxin type A (BoNT-A) is recognized as the treatment of choice for patients with blepharospasm and facial hemispasm. We report the results of long-term BoNT-A therapy (15-20 years) in a group of patients with blepharospasm (9 patients) and hemifacial spasm (18 patients). We evaluated the number of treatment sessions, duration of therapeutic effects, side effects and their frequency during long-term therapy, and the differences between these two groups of patients. We used patient self-assessment and a patient questionnaire to evaluate the influence of the treatment on their quality of life. We have concluded that BoNT-A is an effective and safe long-term treatment of these facial dyskinesias. Despite the different pathophysiology of blepharospasm and facial hemispasm, the therapy effectiveness is comparable. The only differences were in the side effects. In patients with blepharospasm, the side effect frequency was higher and manifested by double vision or eyelid ptosis. In patients with facial hemispasm, the most frequent side effect was lower facial weakness. No association between therapy duration and side effect frequency was determined. Based on patient questionnaires, all patients believed that the treatment was safe and effective with a positive impact on their quality of life, especially in social communication.
A型肉毒毒素（BoNT-A）被公认为是睑痉挛和面部半侧痉挛患者的首选治疗方法。我们报告了一组睑痉挛患者（9例）和面部半侧痉挛患者（18例）接受长期BoNT-A治疗（15 - 20年）的结果。我们评估了治疗疗程数、治疗效果持续时间、长期治疗期间的副作用及其发生频率，以及这两组患者之间的差异。我们采用患者自我评估和患者问卷来评估治疗对其生活质量的影响。我们得出结论，BoNT-A是治疗这些面部运动障碍的一种有效且安全的长期疗法。尽管睑痉挛和面部半侧痉挛的病理生理学不同，但治疗效果相当。唯一的差异在于副作用。在睑痉挛患者中，副作用发生率较高，表现为复视或眼睑下垂。在面部半侧痉挛患者中，最常见的副作用是面部下部肌无力。未确定治疗持续时间与副作用发生频率之间的关联。根据患者问卷，所有患者都认为该治疗安全有效，对他们的生活质量有积极影响，尤其是在社交方面。
