评价肉毒毒素 A 对颜面痉挛患者身心健康的影响。

Evaluation of the effect of botulinum toxin A on the physical and mental health of patients with hemifacial spasm.

机构信息

Department of Neurology, Hongze Huaian District People's Hospital, Huaian 223100, China.

Department of Neurology, The Second People's Hospital of Huai'an, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223002, China.

出版信息

Neurologia (Engl Ed). 2024 Sep;39(7):540-548. doi: 10.1016/j.nrleng.2024.07.001.

DOI:10.1016/j.nrleng.2024.07.001

PMID:39232591

Abstract

BACKGROUND

Hemifacial spasm (HFS) is a debilitating disease characterized by involuntary tonic and clonic contractions of muscles innervated by the facial nerve. Botulinum toxin A (BTX-A) is the first-line option and the most effective medical treatment for HFS. The objective of this study was to evaluate the effect of BTX-A therapy on the physical and mental health of HFS patients.

METHODS

Participants included 65 HFS patients and 65 matched healthy controls in the study. Cornell Medical Index (CMI) self-assessment questionnaire was used to detect the psychological health of all participants. Local injection of BTX-A was applied, and the Cohen hierarchical criteria were employed to stratify the degree of spasticity, further evaluating the efficacy of BTX-A before and two months after treatment in HFS patients. The HFS patients at two months post-treatment were re-evaluated by CMI self-assessment questionnaire, and the evaluated factors of these patients were compared with those of patients before treatment.

RESULTS

The scores of somatization, depression, anxiety, inadaptation, sensitivity, anger, tension, M-R, and total scores in the HFS group were significantly higher than those in the control group (all P<0.05). Two months post-treatment, among 65 HFS patients who received with BTX-A treatment, 42 (64.6%) were completely relieved, 16 (24.6%) were significantly relieved, 7 (10.8%) were partially relieved, and 0 (0%) cases were invalid, and the total effective rate was 89.2%. Two months after BTX-A treatment, the scores of somatization, tension, anxiety, depression, sensitivity, M-R and total scores of patients with HFS were lower than those before treatment (all P<0.05).

CONCLUSIONS

Patients with HFS are often accompanied by somatization, anger, inadaptation, sensitivity, anxiety, depression, and tension. BTX-A can not only alleviate the symptoms of HFS, but also improve the somatization, tension, anxiety, depression, and sensitivity.

摘要

背景

面肌痉挛（HFS）是一种使人衰弱的疾病，其特征是面神经支配的肌肉出现不自主的强直性和阵挛性收缩。肉毒毒素 A（BTX-A）是 HFS 的一线治疗方法，也是最有效的医学治疗方法。本研究的目的是评估 BTX-A 治疗对面肌痉挛患者身心健康的影响。

方法

本研究纳入 65 例 HFS 患者和 65 例匹配的健康对照者。采用康奈尔医学指数（CMI）自我评估问卷检测所有参与者的心理健康。局部注射 BTX-A，并采用 Cohen 分层标准对痉挛程度进行分层，进一步评估 HFS 患者治疗前和治疗后两个月的 BTX-A 疗效。治疗后两个月的 HFS 患者再次接受 CMI 自我评估问卷评估，比较治疗前后患者的评估指标。

结果

HFS 组的躯体化、抑郁、焦虑、不适应、敏感、愤怒、紧张、M-R 和总分评分均明显高于对照组（均 P<0.05）。65 例接受 BTX-A 治疗的 HFS 患者中，治疗后完全缓解 42 例（64.6%），显著缓解 16 例（24.6%），部分缓解 7 例（10.8%），无效 0 例（0%），总有效率为 89.2%。BTX-A 治疗后 2 个月，HFS 患者的躯体化、紧张、焦虑、抑郁、敏感、M-R 和总分评分均低于治疗前（均 P<0.05）。