Objective To investigate the effects of local injection of Botulinum toxin A (BTX-A) on hemifacial spasm guided by periph-eral nerve stimulation. Methods 57 patients with hemifacial spasm from January, 2012 to June, 2015 received local multi-point injection of BTX-A guided by peripheral nerve stimulation. The grades of facial spasm were evaluated before, 72 hours and 6 months after treatment. They were followed up for 3-9 months. Results The spasm reduced in the patients both 72 hours and 6 months after treatment (χ2=4.946, P<0.05). The incidence was 98.25% of satisfaction and 92.99% of very well 72 hours after treatment, while it was 91.23% and 78.95% 6 months after treatment. The relief of spasm was maintained for (23.1 ± 2.3) weeks. Conclusion Injection of BTX-A guided by peripheral nerve stimulation is effective on hemifacial spasm for a long time.

Objective To investigate the Scale (GMFM-88) before and 1 week, 3 months and 6 months after treatment. Results The scores of MAS decreased significantly 1 week, 3 months and 6 months after treatment (P<0.001). The scores of GMFM-88 increased 3 months and 6 months after treatment (P<0.001). Conclusion Injection of BTX-A guided by peripheral nerve stimulation is effective on spastic cerebral palsy.

Objective To observe the therapeutic effects of balloon dilatation with ice water and room temperature water on cricopharyngeal achalasia after brainstem stroke.Methods Forty dysphagic patients with cricopharyngeal achalasia after brainstem stroke were recruited.Twenty patients assigned to experimental group were treated by balloon dilatation with ice water and low frequency elecrtrical stimulation.Twenty patients assigned to control group were treated by balloon dilatation with room temperature water and low frequency electrical stimulation.Results After treatment,36 out of the 40 patients of the two groups could eat pasty food independently without choking.Videofluoroscopic swallowing study (VFSS) showed that the cricopharyngeal sphincter relaxed and the foods passed successfully when swallowing bolus,and no aspiration happened.In comparison,the level of cricopharyngeal opening,the number of patients with nasogastric tube remained and eating normally,and the scores of functional oral intake scale (FOIS) between the two groups showed no significant difference (P ＞ 0.05).The average treatment sessions,average hospitalization days and average treatment cost in treatment group were significantly less than those in the control group(P ＜0.05).Conclusion Cricopharyngeal achalasia can be treated effectively by balloon dilatation with ice water or with room temperature water combined with low frequency electrical stimulation,but treatment course of balloon dilatation with ice water were significantly shorter than that of balloon dilatation with room temperature water.

Objective To observe the therapeutic efficacy of electrical stimulation and balloon dilatation in treating cricopharyngeal achalasia after a brainstem stroke.Methods Thirty dysphagia patients with cricopharyngeal achalasia after a brainstem stroke were randomly divided into an experimental group and a control group, each of 15.The experimental group was given real-time electrical stimulation and balloon dilatation, while the control group was treated using common electrical stimulation and balloon dilatation.Results Twenty-six patients in the 2 groups returned to oral feeding after treatment.Videofluoroscopy revealed that the cricopharyngeal sphincter had relaxed and the food passed successfully when swallowing.No aspiration was observed.There was no significant difference in swallowing between the two groups, but the average treatment time, days of treatment and cost of therapy in the experimental group were significantly less than in the control group.Conclusions Either real-time electrical stimulation or common electrical stimulation combined with balloon dilatation can treat dysphagia effectively, but the former can shorten the course of treatment and lower its cost.