From the Plastic Surgery Division and the Department of Otorhinolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
Plast Reconstr Surg. 2018 Dec;142(6):1511-1519. doi: 10.1097/PRS.0000000000004981.
There is clinical and experimental evidence that botulinum toxin applied to the healthy side of patients with facial paralysis positively affects functional recovery of the paralyzed side. The authors created an experimental model to study the effects of botulinum toxin injection in the gastrocnemius muscle contralateral to the side of tibial nerve lesion/repair in rats.
Fifty rats were allocated into five groups: group I, control; group II, tibial nerve section; group III, tibial nerve section and immediate neurorrhaphy; group IV, tibial nerve section, immediate neurorrhaphy, and botulinum toxin injected into the contralateral gastrocnemius muscle; and group V, botulinum toxin injected into the gastrocnemius muscle and no surgery. Assessment tools included a walking track, electromyography, gastrocnemius muscle weight measurement, and histologic analysis of the nerve.
Paralysis in group V was transient, with function returning to normal at 8 weeks. At 12 weeks, group V had lower latency levels. At week 12, group IV showed higher functional outcomes and amplitude levels than group III, and lower muscle atrophy on the side injected with botulinum toxin compared with group V.
Transient paralysis of the contralateral gastrocnemius muscle by botulinum toxin type A improved functional recovery in rats that underwent section and repair of the tibial nerve.
有临床和实验证据表明，将肉毒毒素应用于面瘫患者健康侧对面部瘫痪侧的功能恢复有积极影响。作者创建了一个实验模型，以研究肉毒毒素注射到大鼠腓肠肌对侧在胫神经损伤/修复侧的影响。
将 50 只大鼠分为 5 组：I 组，对照组；II 组，胫神经切断；III 组，胫神经切断并立即神经吻合；IV 组，胫神经切断，立即神经吻合，同时向对侧腓肠肌注射肉毒毒素；V 组，向腓肠肌注射肉毒毒素而不进行手术。评估工具包括步态分析、肌电图、腓肠肌重量测量和神经组织学分析。
V 组的瘫痪是短暂的，在 8 周时恢复正常。在 12 周时，V 组的潜伏期较低。在 12 周时，与 III 组相比，IV 组的功能和振幅水平更高，且注射肉毒毒素的一侧肌肉萎缩程度低于 V 组。
肉毒毒素 A 暂时性麻痹对侧腓肠肌可改善胫神经切断和修复后大鼠的功能恢复。
