It is usually treated with botulinum toxin BTX. The classically described unilateral application of BTX results in an asymmetry similar to facial paralysis. The aim of this study was to standardize the treatment of HFS by applying BTX bilaterally to prevent the occurrence of iatrogenic facial asymmetry. On reassessment 15 days later, a complementary dose was administered to patients who exhibited some residual degree of spasm or asymmetry with the aim of determining the dose required to achieve satisfactory spasm control without causing facial asymmetry.
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Objective : To evaluate botulinum toxin A therapy in patients with hemifacial spasm attended in a Neurology Service in Cuba. Patients and methods : 35 patients with hemifacial spasm were treated with botulinum toxin A during 15 months. Some parameters of botulinum toxin were collected including doses, latency, maximum duration and total duration of improvement. Clinical data were determined, such as functional status, gravity, frequency and adverse events.
Results : There was a high percentage of female with hemifacial spasm. Most patients showed a latency of 48 hs, maximum duration until 60 days and total duration of improvement of 3 months.
Functional status decreased through time, independently of hemifacial spasm onset and its origin. Parameters related to functional status, as gravity and frequency also diminished significantly their categories. Botulinum toxin doses were statistically increased over this treatment, independently of any patient conditions.
Only eight patients showed adverse events facial muscle weakness and ptosis. Conclusions : Recovery of functional status, and low rate of adverse events observed during botulinum toxin treatment might suggest that this therapy seems to be effective and low-risk under our conditions.
Keywords: Botulinum toxin , dystonia , hemifacial spasm ,. Powered by.
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2006, Número 4
This is the fifth description in the literature and presents mother and daughter at the ages of 76 and 51 respectively, in whom the left side was affected. They underwent exams of angioresonance that showed dolichobasilar with left side origin in both patients. The exams also demonstrated postero-inferior cerebellar artery very developed and irregularities in the walls of the vertebral and basilar arteries suggestive of arteriosclerosis in the mother and slightly elongated intracranial vessels in the daughter. Literature review and etiology data of the hemifacial spasm are focused. Nos casos mais graves, discreta paresia hemifacial ipsilateral pode ser observada