Jedynak C P, Palfi S, Vidailhet M, Kullmann B
Service de Neurochirurgie du CMC Foch, Suresnes, France.
Rev Neurol (Paris). 1993;149(3):202-6.
Botulinum toxin produces a transient presynaptic focal block at the neuromuscular junction. Thus it induces muscle weakness which has a significant beneficial effect on hemifacial spasm. Fifty-four patients were treated and received at least 2 and at the most 22 consecutive injections over a 5-year period. Injections were repeated every 9 weeks on average. The interval between injections corresponded to the time elapsed between the last injection and the re-emergence of spasms. Nineteen patients abandoned the treatment for various reasons. The most frequent side-effect was a ptosis which was observed in 1 out of 6 injections. Ptosis is due to diffusion of the botulinum toxin over a territory larger than expected. The results obtained in 42 patients were analyzed: there was no effect in 7 patients (17%); 11 patients improved by less than 50%; 13 by 50 to 70% and 11 more than 75%.
肉毒杆菌毒素在神经肌肉接头处产生短暂的突触前局灶性阻滞。因此，它会诱发肌肉无力，这对偏侧面肌痉挛有显著的有益效果。54例患者接受了治疗，在5年期间至少接受了2次且最多22次连续注射。平均每9周重复注射一次。注射间隔对应于最后一次注射与痉挛再次出现之间的时间。19例患者因各种原因放弃治疗。最常见的副作用是上睑下垂，每6次注射中就有1次出现。上睑下垂是由于肉毒杆菌毒素扩散到比预期更大的区域所致。对42例患者的结果进行了分析：7例患者（17%）无效；11例患者改善不到50%；13例患者改善50%至70%；11例患者改善超过75%。
