Anti-convulsion effect of botulinum toxin A on Meige's syndrome
- VernacularTitle:A型肉毒毒素在Meige综合征中的抗痉挛作用
- Author:
Heqing HUANG
;
Kangning CHEN
;
Li CHEN
;
Mingkui LUO
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2005;9(37):132-133
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Botulinum toxin A has been applied to treat muscular convulsion by local injection and shows obvious effects in reducing muscular hypertonia with fewer side effects.OBJECTIVE: To assess the effect of botulinum toxin A on Meige's syndrome concerning facial convulsion, therapeutic effect, and side effects.DESIGN: Randomized self-control clinical study.SETTING: Neurological Department of Southwest Hospital Affiliated to the Third Military Medical University of Chinese PLA.PARTICIPANTS: Between June 2000 and May 2003, 24 outpatients were confirmed of having Meige's syndrome at the Neurological Department of Southwest Hospital, the Third Military Medical University of Chinese PLA and volunteered to receive botulinum toxin A (BTA) injection. Meige's syndrome was presented by convulsive eyelid closure in 10 cases, grinding teeth and smacking movement in 3 cases, involuntary blinking in 2 cases,frowning in 1 case, and mixed manifestations in 8 cases.METHODS: Totally 24 patients with Meige's syndrome were subjected to BTA injection at multiple spots of convulsive muscles by dosage of 2.5-5 U in each spot. Improvement of facial convulsion and curative effects were assessed at least once by clinical examination or telephone follow-up. Convulsion was graded in four degrees according to Cohen's scaling standard.Curative effects: [1] Complete alleviation: Convulsion was reduced to grade 0. [2] Obvious alleviation: Convulsion dropped by more than two grades. [3]Partial alleviation: Convulsion dropped by one grade. [4] Ineffective: Convulsion was not attenuated.MAIN OUTCOME MEASURES: [1] Changes of muscular convulsion intensity after BTA injection in patients with Meige's syndrome; [2] improvement of various symptoms after BTA injection; [3] side effects of BTA.RESULTS: Totally 24 patients entered the result analysis. [1] Before treatment, there were one case of grade 0- Ⅰ, 7 cases of grade Ⅱ, 10 cases of grade Ⅲ and 6 cases of grade Ⅳ, as compared to 16, 6, 2 and 0 cases, respectively, after treatment (χ2 = 95.489 4, P = 7.313 41×10-10). [2] BTA could alleviate eyelid convulsion in an average of 3 days, with curative effect reaching the peak in 2 weeks. Symptoms were found to be completely alleviated in 75% (18/24), obviously alleviated in 17% (4/24) and partially alleviated in 8% (2/24), with the total efficiency of 100%. The effective duration was 8-44 weeks with the average of 24.4 weeks. [3] Muscle weakness at the injected spot and incomplete muscular paralysis at the uninjected spots occurred for a short time after injection, but were alleviated automatically within 1-8 weeks.CONCLUSION: BTA can obviously reduce convulsive degree and enhance the effects in treating Meige's syndrome; moreover, selection of muscles to be injected into and injection spots will help reduce side effects.
