Department of Neurology, Abant İzzet Baysal University, Bolu, Turkey.
Neurology Clinic, Dişkapı Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Int J Neurosci. 2021 Jun;131(6):549-554. doi: 10.1080/00207454.2020.1750389. Epub 2020 Apr 15.
The aim of the present study was to evaluate the effects of different doses of onabotulinum toxin A on the amplitude and latency values of the blink reflex and facial nerve in the pretarsal and preseptal portions of the orbicularis oculi muscle in patients with hemifacial spasm.
Thirty patients with hemifacial spasm were assigned in two equal groups: Pretarsal Group: Five units of onabotulinum toxin A were injected into each of 2 points of the pretarsal portion; Preseptal Group: Five units of onabotulinum toxin A was injected into 4 points of the preseptal portion. We compared the electromyographic features of the patients before and 5 weeks after botulinum toxin (BTX) injection.
In comparison of pre- and post-treatment measurements of blink reflex amplitude responses, the decreases in R1 ( = 0.003), R2 ( < 0.001), and R2C amplitudes ( = 0.031) were found to be significant in the BTX injected side in the pretarsal group. In the comparison of pre- and post-treatment measurements of facial nerve compound action potential amplitude changes, decreases in the amplitudes of the BTX injected (ipsilateral), and uninjected (contralateral) side in the pretarsal group were found to be significant ( < 0.001 for both groups). Decreases in the amplitudes of the BTX injected, and uninjected side in the preseptal group were found to be significant ( < 0.001, and = 0.008, respectively).
According to our hypothesis, the smaller amount of BTX applied to the pretarsal portion was found to be more effective than higher amount of BTX injected into the preseptal portion of the orbicularis oculi muscle.
本研究旨在评估不同剂量的肉毒毒素 A 对眼睑反射和眼轮匝肌额部和眶部面神经潜伏期和振幅值的影响。
将 30 例面肌痉挛患者分为两组：额部组：在额部 2 点各注射 5 个单位肉毒毒素 A；眶部组：在眶部 4 点各注射 5 个单位肉毒毒素 A。我们比较了患者在肉毒毒素（BTX）注射前后的肌电图特征。
与治疗前相比，额部组 BTX 注射侧的眨眼反射幅度反应 R1（=0.003）、R2（<0.001）和 R2C 振幅（=0.031）均显著降低。与治疗前相比，额部组 BTX 注射（同侧）和未注射（对侧）侧的面神经复合动作电位振幅变化测量值均显著降低（两组均<0.001）。眶部组 BTX 注射侧和未注射侧的振幅均显著降低（两组均<0.001，眶部组为 0.008）。
根据我们的假设，额部注射较小剂量的 BTX 比眶部注射更大剂量的 BTX 更有效。
