Poungvarin N, Devahastin V, Viriyavejakul A
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1995 Jun;78(6):281-8.
A prospective open study of botulinum toxin A treatment for patients with various movement disorders at Siriraj Hospital, Mahidol University was analysed to evaluate its efficacy. The grand total of 900 patients comprised of a) 592 patients (65.78 per cent) with hemifacial spasm; b) 92 patients (10.22 per cent) with occupational cramp; c) 79 patients (8.78 per cent) with blepharospasm and Meige syndrome; d) 72 patients (8.00 per cent) with spasmodic torticollis; e) 19 patients (2.11 per cent) with hemidystonia and generalised dystonia; f) 11 patients (1.22 per cent) with spasmodic dysphonia; g) 10 patients (1.11 per cent) with spastic hemiparesis; and h) 25 patients (2.78 per cent) with miscellaneous group (i.e. tics, Gilles de la Tourette, facial myokimia, benign fasciculation, etc.). The results of treatment for hemifacial spasm were classified as excellent in 486 patients (82.09 per cent), moderate improvement in 60 patients (10.14 per cent), mild improvement in 39 patients (6.59 per cent) and no improvement or worse in 7 patients (1.18 per cent). There were complications of mild transient facial weakness in 50 patients (8.45 per cent) and mild ptosis in 12 patients (2.02 per cent). The effect of botulinum toxin treatment lasted 3-6 months. In occupational cramp and spasmodic torticollis the good response rate was around two-thirds of all patients, whereas, blephalospasm, spasmodic dysphonia, spastic hemiparesis and tics responsed in 79-88 per cent of the patients. Botulinum toxin A injection is thus a simple, safe, and effective out-patient treatment for patients with various kinds of movement disorders but it is a costly therapy.
对泰国玛希隆大学诗里拉吉医院各类运动障碍患者接受A型肉毒杆菌毒素治疗的一项前瞻性开放性研究进行了分析，以评估其疗效。总计900名患者包括：a）592名（65.78%）面肌痉挛患者；b）92名（10.22%）职业性肌痉挛患者；c）79名（8.78%）眼睑痉挛和梅杰综合征患者；d）72名（8.00%）痉挛性斜颈患者；e）19名（2.11%）偏侧肌张力障碍和全身性肌张力障碍患者；f）11名（1.22%）痉挛性发声障碍患者；g）10名（1.11%）痉挛性偏瘫患者；以及h）25名（2.78%）其他类别患者（即抽动症、图雷特综合征、面部肌纤维颤搐、良性肌束震颤等）。面肌痉挛的治疗结果分类如下：486名患者（82.09%）为优，60名患者（10.14%）为中度改善，39名患者（6.59%）为轻度改善，7名患者（1.18%）无改善或病情恶化。有50名患者（8.45%）出现轻度短暂性面部无力并发症，12名患者（2.02%）出现轻度上睑下垂。肉毒杆菌毒素治疗的效果持续3至6个月。在职业性肌痉挛和痉挛性斜颈方面，良好反应率约为所有患者的三分之二，而眼睑痉挛、痉挛性发声障碍、痉挛性偏瘫和抽动症患者的反应率为79%至88%。因此，A型肉毒杆菌毒素注射对于各类运动障碍患者而言是一种简单、安全且有效的门诊治疗方法，但它是一种昂贵的疗法。
