RESUMO
The articles regarding needle-embedding treatment for hemifacial spasm published before September 30, 2019 were searched from SinoMed, Wanfang, CNKI, VIP and PubMed database, and were analyzed and summarized from treatment methods, acupoint selection, stage differentiation and action mechanism. As a result, 45 Chinese articles were obtained. The needle-embedding treatment was divided into intradermal needling and acupoint thread-embedding; the top five acupoints were Sibai (ST 2), Taiyang (EX-HN 5), Dicang (ST 4), Jiache (ST 6) and spasm trigger points. The basic research of needle-embedding treatment for hemifacial spasm is weak, and the literature regarding stage differentiation is insufficient, which are in need of further study.
Assuntos
Terapia por Acupuntura , Espasmo Hemifacial , Meridianos , Pontos de Acupuntura , Espasmo Hemifacial/terapia , Humanos , AgulhasAssuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Terapia por Exercício , Músculos Faciais , Espasmo Hemifacial/terapia , Fármacos Neuromusculares/uso terapêutico , Qualidade de Vida , Adulto , Estudos Cross-Over , Espasmo Hemifacial/complicações , Espasmo Hemifacial/psicologia , Humanos , Projetos Piloto , TailândiaRESUMO
BACKGROUND: Facial spasm causes a lot of troubles to patients daily life and seriously affects their mental and physical health. Relevant studies have shown that fire needle therapy has certain benefits for facial spasm, is an integral part of acupuncture therapy. However, there is no unanimous conclusion. The main purpose of our study is to measure whether fire needle therapy is effective for facial spasm. METHODS: The following electronic databases will be searched for the collection of fire-needle related randomized controlled trials (RCTS) for facial spasm, including 4 English databases (Web of Science, the Cochrane Library, EMBASE, Pubmed) and 3 Chinese databases (Chinese National Knowledge Infrastructure [CNKI], Wanfang data, Chinese VIP Information). The cure rate and total effective rate are the main outcomes, while the intensity, frequency, recurrence rate and adverse events are the secondary outcomes. We will use Endnote software X9 for study selection, Review Manager software 5.4 and STATA 13.0 software for analysis and synthesis. RESULTS: We will evaluate the efficacy of fire needles in the treatment of facial spasm in combination with current studies. CONCLUSION: The conclusion of this study will provide evidence for the efficacy of fire needle in the treatment of facial spasm. TRIAL REGISTRATION NUMBER: INPLASY202080036.
Assuntos
Terapia por Acupuntura/métodos , Espasmo Hemifacial/terapia , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Temperatura Alta , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoAssuntos
Cefaleia/etiologia , Espasmo Hemifacial/etiologia , Hipotensão Intracraniana/complicações , Hipotensão Intracraniana/diagnóstico , Placa de Sangue Epidural , Feminino , Cefaleia/terapia , Espasmo Hemifacial/terapia , Humanos , Hipotensão Intracraniana/terapia , Imageamento por Ressonância Magnética , Pessoa de Meia-IdadeRESUMO
RESUMEN Introducción: No se encuentran antecedentes de investigaciones que aborden resultados de la aplicación de toxina botulínica tipo A en pacientes con espasmo hemifacial en la provincia Guantánamo. Objetivo: Evaluar los resultados terapéuticos de la aplicación de toxina botulínica tipo A en pacientes con espasmo hemifacial atendidos en consulta de Neurología. Método: Se realizó un estudio descriptivo longitudinal de 21 pacientes atendidos en servicio de Neurología con espasmo hemifacial y tratamiento con toxina botulínica tipo A, desde enero 2018 hasta enero 2019. Las variables estudiadas fueron: edad, sexo, hemicara afectada, periodo de latencia, duración, desaparición del efecto clínico de toxina botulínica tipo A, y porciento de incapacidad funcional en pacientes al aplicar la escala de discapacidad antes y después de la aplicación del tratamiento. Resultados: Predominó el sexo femenino con 57,1%, edad mayor de 55 años con 57,14 %, lado afectado predominante el izquierdo con 57,14 %, el periodo de latencia de la toxina botulínica tipo A fue entre el tercer y décimo día con 14 pacientes para un 66,67 %, el tiempo máximo de duración del tratamiento fue de uno a dos meses con un 57,14 %, y la desaparición del efecto terapéutico de la toxina fue entre el tercer y cuarto mes con un 52,38%. Luego de la aplicación de la escala de evaluación clínica del espasmo hemifacial se evidenció disminución del porcentaje de pacientes con incapacidad funcional. Conclusiones: La toxina botulínica tipo A es efectiva en el tratamiento del espasmo hemifacial.
ABSTRACT Introduction: No research records were founded dressing the results of the application of botulinum toxin type A in patients with hemifacial spasm in Guantanamo province. Objective: to evaluate the therapeutic results of the application of botulinum toxin type A in patients with hemifacial spasm treated in a Neurology consultation. Method: a descriptive and longitudinal study was carried out in 21 patients attended in Neurology service with hemifacial spasm and botulinum toxin type A treatment, fromJanuary 2018 to January 2019. The variables studied were: age, gender, hemiface affected, latency period, duration, disappearance of the clinical effects of botulinum toxin type A, and percentage of functional disability in patients when applying the disability scale before and after the treatment. Results: Female cases predominated (57.1%), agesover 55 years (57.14 %), the most common affected side of the face was the left, with 57.14 %, the latency period of botulinum toxin type A was between the third to the tenth day in 14 of the patients (66.67 %), the maximum time of duration of treatment ranged from one to two months (57.14 %), and the disappearance of the therapeutic effect of the toxin in the patients was between the third to the fourth month (52.38%). After the application of the clinical assessment scale of hemifacial spasm, a decrease in the percentage of patients with functional disability was evidenced. Conclusions: Botulinum toxin type A is effective in the treatment of hemifacial spasm.
Assuntos
Humanos , Resultado do Tratamento , Toxinas Botulínicas Tipo A/uso terapêutico , Espasmo Hemifacial/terapia , Epidemiologia Descritiva , Estudos LongitudinaisAssuntos
Blefarospasmo/fisiopatologia , Doenças do Nervo Facial/fisiopatologia , Espasmo Hemifacial/fisiopatologia , Mioquimia/fisiopatologia , Músculos Oculomotores/fisiopatologia , Sincinesia/fisiopatologia , Inibidores da Liberação da Acetilcolina/uso terapêutico , Benzodiazepinas/uso terapêutico , Blefarospasmo/complicações , Blefarospasmo/diagnóstico , Blefarospasmo/terapia , Toxinas Botulínicas Tipo A/uso terapêutico , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/terapia , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/terapia , Espasmo Hemifacial/complicações , Espasmo Hemifacial/diagnóstico , Espasmo Hemifacial/terapia , Humanos , Lubrificantes Oftálmicos/uso terapêutico , Cirurgia de Descompressão Microvascular , Mioquimia/complicações , Mioquimia/diagnóstico , Mioquimia/terapia , Músculos Oculomotores/cirurgia , Sincinesia/complicações , Sincinesia/diagnóstico , Sincinesia/terapiaRESUMO
Botulinum toxin A is a kind of neurotoxin produced by clostridium botulinum, and has been applied for nearly thirty years in China.The target of BTX-A is to selectively cleave the synaptosome-associated protein of 25 KD molecular mass, commonly abbreviated SNAP-25, thereby inhibiting neurotransmitter release and causing chemodenervation. The potential application of botulinum toxin A in treating the spasmodic dysphonia, hemifacial spasm, tinnitus, rhinitis has been confirmed both in clinical practice and previous studies. This paper is to review comprehensively the application status and the prospect of botulinum toxin A in otorhinolaryngological treatment.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Bloqueio Nervoso , China , Disfonia/terapia , Espasmo Hemifacial/terapia , Humanos , Rinite/terapia , Zumbido/terapiaRESUMO
BACKGROUND: Hemifacial spasm (HFS) brings a lot of trouble to patients' daily life, having a severe influence on the psychological and physical wellbeing of patients. Relevant researches suggested that acupuncture therapy has potential benefits for HFS. However, there is no consistent conclusion. The purpose of our study is to assess whether acupuncture therapy is effective and safe for HFS. METHODS: To collect relevant randomized controlled trials (RCTs), the following electronic databases will be searched: Web of Science, the Cochrane Library, EMBASE, MEDLINE, ISI Web of Knowledge, PsycINFO, Allied and Alternative Medieine, Chinese National Knowledge Infrastructure, Wanfang data, and Chinese Scientific Journals Database. We will take the cure rate and the total effective rate as the primary outcomes, and change in intensity after treatment, change in frequency after treatment, the recurrence rate, and adverse events as secondary outcomes. Endnote software 9.1 will be used for study selection, Review Manager software 5.3, and STATA 13.0 software will be used for analysis and synthesis. RESULTS: Current relevant studies will be synthesized to assess whether acupuncture therapy is effective and safe for HFS. CONCLUSION: Our research will provide evidence of acupuncture therapy for HFS. REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42019142473.
Assuntos
Terapia por Acupuntura , Espasmo Hemifacial/terapia , Humanos , Metanálise como Assunto , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como AssuntoRESUMO
Background: Linear scleroderma has been associated with muscle spasms ipsilateral to skin lesions. Typically, spasms are located in trigeminal innervated muscles, leading to hemimasticatory spasm (HMS). Case Report: We report a case of linear scleroderma associated with spasm of muscles innervated not only by the trigeminal but also by the facial nerve. Discussion: We review the patient's successful treatment with incobotulinumtoxinA, a formulation of botulinum toxin that has not been reported for use in this condition.
Assuntos
Espasmo Hemifacial/diagnóstico , Espasmo Hemifacial/terapia , Esclerodermia Localizada/complicações , Adulto , Toxinas Botulínicas Tipo A/uso terapêutico , Espasmo Hemifacial/complicações , Humanos , Masculino , Fármacos Neuromusculares/uso terapêuticoRESUMO
Botulinum toxin is recognised as the gold standard for the treatment of essential blepharospasm and hemifacial spasm, which is similar in effect in synkinesis after facial nerve palsy. The injection intervals can be adjusted according to the patients' needs and be shortened for up to six weeks in cases of eyelid cramping. Newer indications for the use of botulinum toxin in ophthalmology include eyelid retraction in Graves' disease, induction of protective ptosis and treatment of crocodile tears syndrome after facial nerve palsy. In future, botulinum toxin may be used in depression (facial feedback), facial injuries and for protection of facial glands against irradiation injury.
Assuntos
Blefaroptose , Blefarospasmo , Toxinas Botulínicas , Espasmo Hemifacial , Blefaroptose/terapia , Blefarospasmo/terapia , Toxinas Botulínicas/uso terapêutico , Toxinas Botulínicas Tipo A , Espasmo Hemifacial/terapia , Humanos , Oftalmologia/métodosRESUMO
OBJECTIVE: Facial Myokymia and hemifacial spasm have been associated with multiple sclerosis; however, their etiology and clinical outcome is uncertain. Here, we describe the clinical, radiologic features, and treatment outcomes of a cohort of patients with multiple sclerosis and history of facial myokymia or hemifacial spasm. METHODOLOGY: We reviewed the clinical features, radiologic features, and treatment outcomes of 35 patients with a diagnosis of multiple sclerosis and facial myokymia (28) or hemifacial spasm (7) seen at Mayo Clinic (Rochester, MN). RESULTS: Facial myokymia was associated with a clinical or radiologic relapse in 11 of 28 patients. In 27 of 28 patients with facial myokymia, symptom resolution occurred within months regardless of treatment. An ipsilateral pontine lesion was found in 3 of 7 cases with hemifacial spasm. Hemifacial spasm was associated with a clinical or radiologic relapse in 3 of 7 cases. Hemifacial spasm resolved within 4 years in 5 of 7 cases, with the remaining cases persisting up to 9 years despite treatment. CONCLUSIONS: Facial myokymia and hemifacial spasm occurring in patients with multiple sclerosis is associated with an ipsilateral pontine MRI lesion in a minority of patients. Facial myokymia is a self-limited process while hemifacial spasm can be persistent in a minority of patients, despite treatment.
Assuntos
Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/terapia , Espasmo Hemifacial/diagnóstico , Espasmo Hemifacial/terapia , Esclerose Múltipla/complicações , Adolescente , Adulto , Idoso , Estudos de Coortes , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/patologia , Feminino , Espasmo Hemifacial/etiologia , Espasmo Hemifacial/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ponte/diagnóstico por imagem , Ponte/patologia , Resultado do Tratamento , Adulto JovemRESUMO
Accurate and long-term transposition of offending vessels is required in microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS) and trigeminal neuralgia (TN). We created ion-beam implanted of an expanded-polytetrafluoroethylene (i-ePTFE) surface to transpose offending vessels in MVD. In 13 patients with MVD, we concealed and transposed offending vessels with tape-shaped i-ePTFE, and relieved facial and trigeminal nerve compression by attaching the i-ePTFE to the dura with fibrin glue. After surgery, none of the patients reported further symptoms or experienced recurrence of symptoms up to 12 months post-surgery. Favorable surgical outcomes are obtainable, since i-ePTFE has high tissue affinity and is easy to manipulate, even under a narrow and deep operative field. Our results suggested that i-ePTFE is very useful for transposition in MVD.
Assuntos
Espasmo Hemifacial/terapia , Cirurgia de Descompressão Microvascular/instrumentação , Politetrafluoretileno , Próteses e Implantes , Neuralgia do Trigêmeo/terapia , Adulto , Idoso , Estudos de Coortes , Dura-Máter , Feminino , Adesivo Tecidual de Fibrina , Humanos , Masculino , Pessoa de Meia-Idade , Radiação Ionizante , Resultado do TratamentoRESUMO
Objetivo: evaluar los resultados terapéuticos de la aplicación de toxina botulínica A en pacientes con alteraciones espásticas palpebrales. Métodos: se realizó un estudio observacional, descriptivo, longitudinal y prospectivo en 18 pacientes con estas afecciones, seleccionados en la consulta de Oculoplastia del Instituto Cubano de Oftalmología Ramón Pando Ferrer en el período comprendido entre enero y diciembre del año 2016. Se describió la muestra según la edad, el sexo, el color de la piel, los antecedentes patológicos personales, las afecciones palpebrales y las limitaciones en tareas de la vida diaria. Se evaluó en el posoperatorio el tiempo de desaparición de los síntomas, la duración del efecto de la inyección de toxina botulínica, las complicaciones inmediatas y las mediatas. Resultados: el 70,6 por ciento estuvo comprendido en el rango de edad mayor de 60 años, y el 52,9 por ciento fueron mujeres. La piel blanca constituyó el 58,8 por ciento de la muestra. La afección que se presentó con mayor frecuencia fue el blefaroespasmo (47,1 por ciento). Todos los pacientes presentaron limitaciones para realizar tareas de la vida diaria. El 100 por ciento presentó dolor en el sitio de la inyección. En el 94,1 por ciento de ellos hubo desaparición de los movimientos involuntarios entre el cuarto y el quinto día posterior a la aplicación de xeomeen y en el 88,2 por ciento demoró la reaparición de los síntomas entre cuatro y seis meses. Conclusiones: la toxina botulínica es efectiva en la corrección de las afecciones palpebrales espásticas con desaparición de los síntomas en un período de tiempo entre cuatro y cinco días, con una rápida incorporación del paciente a la vida laboral y social por cuatro a seis meses(AU)
Objective: to evaluate the therapeutic results of the application of toxin botulínica A in patients with palpebral spastic alterations. Methods: an observational, descriptive, longitudinal and prospective study was performed on 18 patients with these conditions, who were selected at the Oculoplasty Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period from January to December 2016. The analyzed variables were age, sex, race, personal pathological history, eyelid disorders and restricted daily life. In the postoperative period, length of time for symptom relief, duration of the effect of botulinum toxin injection, and immediate and mediate complications were assessed. Results: in the group, 70,6 percent were included in the over 60 y age group and 52,9 percent were women. Caucasians accounted for 58,8 percent of the sample. The most frequent condition was blepharospasm (47,1 percent). All patients had limitations to perform daily life tasks. In 94,1 percent of the patients, involuntary movements disappeared between the 4th and the 5th day after the administration of Xeomeen and in 88,2 percent, the symptoms delayed to appear again from 4 to 6 months. Conclusions: botulinum toxin A is an effective alternative to correct palpebral spastic conditions, with symptoms disappearing in four to five days, and quick reincorporation of the patient to working and social life for 4 to 6 months(AU)
Assuntos
Humanos , Feminino , Blefarospasmo/terapia , Toxinas Botulínicas Tipo A/uso terapêutico , Espasmo Hemifacial/terapia , Glândulas Tarsais/lesões , Epidemiologia Descritiva , Estudos Longitudinais , Estudo Observacional , Estudos ProspectivosRESUMO
'Painful tic convulsif' (PTC) describes the coexistence of hemifacial spasm and trigeminal neuralgia. In this report, we describe a unique presentation of bilateral PTC in a man with bilateral hemifacial spasm and trigeminal neuralgia secondary to neurovascular conflict of all four cranial nerves. Following failed medical and radiofrequency therapy, microvascular decompression of three of the four involved nerves was performed, where the offending vessels were mobilised and Teflon used to prevent conflict recurrence. He continues to respond to Botox for right hemifacial spasm. Since surgery, he remains pain free bilaterally and spasm free on the left.
Assuntos
Inibidores da Liberação da Acetilcolina/uso terapêutico , Toxinas Botulínicas Tipo A/uso terapêutico , Nervos Cranianos/fisiopatologia , Espasmo Hemifacial/fisiopatologia , Cirurgia de Descompressão Microvascular/métodos , Tiques/fisiopatologia , Neuralgia do Trigêmeo/fisiopatologia , Idoso , Progressão da Doença , Espasmo Hemifacial/etiologia , Espasmo Hemifacial/terapia , Humanos , Masculino , Tiques/etiologia , Tiques/terapia , Resultado do Tratamento , Neuralgia do Trigêmeo/complicações , Neuralgia do Trigêmeo/terapiaRESUMO
Hemifacial spasm (HFS) is one of the most common presentations in patients with cranial psychogenic (functional) movement disorders (PMD). Medical records and videos of patients with PMD and HFS were reviewed to identify those with psychogenic HFS and to compare the phenomenology of psychogenic HFS with organic HFS. We identified 18 (9.8%) patients with psychogenic HFS from a cohort of 184 patients with PMDs. There were 14 (78%) women and 4 men, with a mean age at onset of 33 ± 13.5 years. These were compared with 37 consecutive patients with organic (primary) HFS. Patients with psychogenic HFS were significantly younger and had more frequently tonic muscle contractions, bilateral asynchronous hemifacial involvement, isolated lower facial involvement, downward deviation of the mouth's angle, and lack of the "other Babinski sign" compared to those with organic HFS. Other features such as ipsilateral downward movements of the eyebrow; associated tremor, dystonia and hemi-masticatory spasms were more frequently observed in patients with psychogenic HFS but these differences did not reach statistical significance. Lack of other Babinski sign and tonic muscle contractions showed the highest sensitivity (1.00 and 0.87, respectively), whereas downward mouth's angle deviation showed the highest specificity (1.00) for the diagnosis of psychogenic HFS. Besides other features such as suggestibility, distractibility, periods of unexplained improvements observed in most patients with PMDs, several clinical features, such as tonic muscle contractions, downward mouth's angle deviation, predominant lower facial and bilateral involvement, may be helpful in distinguishing psychogenic from organic HFS.
Assuntos
Espasmo Hemifacial/diagnóstico , Espasmo Hemifacial/etiologia , Transtornos Psicofisiológicos/complicações , Transtornos Psicofisiológicos/diagnóstico , Adulto , Fatores Etários , Comorbidade , Diagnóstico Diferencial , Face/patologia , Face/fisiopatologia , Músculos Faciais/fisiopatologia , Feminino , Predisposição Genética para Doença , Espasmo Hemifacial/fisiopatologia , Espasmo Hemifacial/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Contração Muscular , Transtornos Psicofisiológicos/fisiopatologia , Transtornos Psicofisiológicos/terapia , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: About 5-15% of people in the Western world will suffer from an extended period of tinnitus during their lifetime. This is often a non-treatable, disabling disorder. Tinnitus can be classified as pulsatile or non-pulsatile. Pulsatile tinnitus can be caused by a treatable neurovascular compression. CASE DESCRIPTION: Here we describe two patients, a 68-year old woman and 40-year old man suffering from pulsatile tinnitus and hemifacial spams due to neurovascular compression of the facial and acoustic nerve in the anterior cranial fossa. After microvascular decompression using the Jannetta procedure, in which a sponge was placed between the blood vessel and the nerve, the tinnitus and hemifacial spasm disappeared. CONCLUSION: Recognition of hemifacial spasm in patients with tinnitus is important because the symptoms are treatable when it is due to neurovascular compression. Because hemifacial spasm can manifest in subtle forms - for instance unilateral blinking - this important symptom can easily be overlooked.
Assuntos
Espasmo Hemifacial/etiologia , Síndromes de Compressão Nervosa/complicações , Zumbido/etiologia , Adulto , Idoso , Descompressão Cirúrgica , Doenças do Nervo Facial/complicações , Doenças do Nervo Facial/cirurgia , Feminino , Espasmo Hemifacial/terapia , Humanos , Masculino , Síndromes de Compressão Nervosa/cirurgia , Zumbido/terapia , Doenças do Nervo Vestibulococlear/complicações , Doenças do Nervo Vestibulococlear/cirurgiaRESUMO
IMPORTANCE: Patients with benign essential blepharospasm or hemifacial spasm are known to use botulinum toxin injections and alleviating maneuvers to help control their symptoms. The clinical correlates between the use of botulinum toxin injections and the use of alleviating maneuvers are not well established. OBJECTIVE: To determine whether the use of alleviating maneuvers for benign essential blepharospasm or hemifacial spasm correlates with disease severity or botulinum toxin treatment. DESIGN, SETTING, AND PARTICIPANTS: A prospective cross-sectional observational study (designed in September 2013) of 74 patients with benign essential blepharospasm and 56 patients with hemifacial spasm who were consecutively recruited from adnexal clinics at Moorfields Eye Hospital (January-June 2014) to complete a questionnaire and undergo a clinical review. Data analysis was performed in December 2015. MAIN OUTCOMES AND MEASURES: Prevalence and type of alleviating maneuvers used for blepharospasm and hemifacial spasm, dystonia severity, and dose and frequency of botulinum toxin injections. RESULTS: Of the 74 patients with blepharospasm, 39 (52.7%) used alleviating maneuvers (mean [SD] age, 70.4 [9.1] years); of the 56 patients with hemifacial spasm, 25 (44.6%) used alleviating maneuvers (mean [SD] age, 66.5 [12.7] years). The most commonly used maneuver was the touching of facial areas (35 of 64 patients [54.7%]); other maneuvers included covering the eyes (6 of 64 patients [9.4%]), singing (5 of 64 patients [7.8%]), and yawning (5 of 64 patients [7.8%]). Patients with blepharospasm who used alleviating maneuvers scored higher on the Jankovic Rating Scale (median score, 5 vs 4; Hodges-Lehmann median difference, 1 [95% CI, 0-2]; P = .01) and the Blepharospasm Disability Index severity score (median score, 11 vs 4; Hodges-Lehmann median difference, 4 [95% CI, 1-7]; P = .01) than patients with blepharospasm who did not use alleviating maneuvers. Patients with hemifacial spasm who used alleviating maneuvers scored higher on the 7-item Hemifacial Spasm Quality of Life scale (median score, 7 vs 3; Hodges-Lehmann median difference, 4 [95% CI, 1-7]; P = .01) and the SMC Severity Grading Scale (median score, 2 vs 2; Hodges-Lehmann median difference, 0 [95% CI, 0-1]; P = .03) than patients with hemifacial spasm who did not use alleviating maneuver. The severity of dystonia correlated with botulinum toxin treatment for patients with blepharospasm (r = 0.23; P = .049) and patients with hemifacial spasm (r = 0.45; P = .001). There was no difference found in botulinum toxin treatment between patients who used alleviating maneuvers and those who did not, in either the blepharospasm group (150 vs 125 units; Hodges-Lehmann median difference, 20 units [95% CI, -10 to 70 units]; P = .15) or the hemifacial spasm group (58 vs 60 units; Hodges-Lehmann median difference, 0 units [95% CI, -15 to 20 units]; P = .83). CONCLUSIONS AND RELEVANCE: Half of the patients with periocular facial dystonias used alleviating maneuvers. Their use was associated with more severe disease but not with increased use of botulinum toxin. This may help to guide future therapies, such as advice on maneuver augmentation or tailored devices.
Assuntos
Blefarospasmo/terapia , Toxinas Botulínicas Tipo A/administração & dosagem , Distonia/terapia , Músculos Faciais/fisiopatologia , Modalidades de Fisioterapia , Idoso , Blefarospasmo/complicações , Blefarospasmo/fisiopatologia , Estudos Transversais , Relação Dose-Resposta a Droga , Distonia/etiologia , Distonia/fisiopatologia , Músculos Faciais/efeitos dos fármacos , Feminino , Espasmo Hemifacial/complicações , Espasmo Hemifacial/fisiopatologia , Espasmo Hemifacial/terapia , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares/administração & dosagem , Estudos Prospectivos , Qualidade de Vida , Resultado do TratamentoRESUMO
Vagoglossopharyngeal neuralgia (VGPN) is a very rare condition. VGPN with convulsive like attack is even rarer All of the cases had their head turned to the opposite side of facial pain. Hemifacial spasm occurring concurrently with VGPN has never been reported. Herein, we present the first case of VGPN that had ipsilateral hemifacial spasm and versive seizure-like movement to the same side of facial pain. We reported a 71-year-old man presenting with multiple episodes of intermittent sharp shooting pain arising on the right middle neck, followed by hemifacial spasm on right face. Then the patient became syncope while his head and gaze turned to the same side of the painful neck. Electrocardiography showed sinus arrest. Interictal Electroencephalography was normal. This patient initially responded to pregabalin for two weeks, then the symptoms became worse. Microvascular decompression and carbamazepine resulted in the complete remission of all symptoms after six months of follow-up. We could not explain the pathophysiology of unilateral versive seizure like movement.
Assuntos
Epilepsia Motora Parcial/complicações , Doenças do Nervo Glossofaríngeo/complicações , Espasmo Hemifacial/complicações , Neuralgia/complicações , Parada Sinusal Cardíaca/complicações , Síncope/complicações , Doenças do Nervo Vago/complicações , Idoso , Carbamazepina/uso terapêutico , Eletrocardiografia , Eletroencefalografia , Epilepsia Motora Parcial/diagnóstico , Epilepsia Motora Parcial/terapia , Doenças do Nervo Glossofaríngeo/diagnóstico , Doenças do Nervo Glossofaríngeo/terapia , Espasmo Hemifacial/diagnóstico , Espasmo Hemifacial/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Cirurgia de Descompressão Microvascular/métodos , Neuralgia/diagnóstico , Neuralgia/terapia , Parada Sinusal Cardíaca/diagnóstico , Parada Sinusal Cardíaca/terapia , Síncope/diagnóstico , Síncope/terapia , Doenças do Nervo Vago/diagnóstico , Doenças do Nervo Vago/terapiaRESUMO
La toxina botulínica es un potente inhibidor neuromuscular altamente específico que produce una denervación química al bloquear la liberación de acetilcolina en la placa motora. Es sintetizada por Clostridium botulinum. Es un fármaco de alto valor terapéutico en las alteraciones de los anexos oculares; puede indicarse con muy buenos resultados en afecciones como el blefarospasmo primario, el espasmo hemifacial, el chalazión, el entropion espasmódico, la retracción palpebral, la ptosis de la ceja, la mioquimia palpebral y en el tratamiento de líneas de expresión facial, con muy buenos resultados estéticos. Se realizó una búsqueda bibliográfica y en Internet utilizando distintas bases de datos como Medline, Google, Bireme, PubMed.gov, así como artículos relevantes de la Academia americana de Oftalmología y Neurología con el objetivo de describir las aplicaciones de la neurotóxica botulínica en las afecciones de los anexos oculares(AU)
Botulinum toxin is a highly specific potent neuromuscular inhibitor that produces a chemical denervation when blocking the release of acetylcholine in the motor plaque. It is synthesized by clostridium botulinum. It is a drug with high therapeutic value to treat ocular adnexas and may be indicated for primary blepharospasm, hemifacial spasm, chalazion, spasmodic entropion, palpebral retraction, eye brow ptosis, palpebral myokymia and in treating expression lines of the face, all with very good esthetic results. Literature search was made in Internet by using databases such as Medline, Google, Bireme, PubMed.gov, as well as outstanding articles of the American Academy of Ophthalmology and Neurology with the objective of describing the uses of botulinum toxin for ocular adnexa diseases(AU)