Botulinum A toxin treatment for eyelid spasm, spasmodic torticollis and apraxia of eyelid opening.
Botulinum-A toxin (botAtox) was used in the treatment of blepharospasm (BS), idiopathic hemifacial spasm (HFS), idiopathic spasmodic torticollis (ST) and apraxia of eyelid opening (AEO). The injection of 7.5-30 U botAtox per eye spread over 3 or 4 sites in the palpebral part of orbicularis palpebrae (OP) reduced palpebral spasm in 12/13 cases of BS and in 7/8 cases of HFS. The effect lasted for 14.5 weeks on average (range 4-30 weeks). Palpebral ptosis (lasting 1-3 weeks) was the most frequent side effect (16/107 eyes treated) but was not related to dose of botAtox or number of inoculation sites. Injection of 60-160 U botAtox into the sternocleidomastoid, trapezius and splenius capitis muscles reduced ST objectively in 1/4 patients for about 4 weeks. In the other patients the reduction or abolition of the hypertrophy of the previous hyperactive muscles was accompanied by persistence or rearrangement of the dystonia pattern, suggesting a change in the pattern of activity of the neck muscles after botAtox. 5 U botAtox per eye spread over 4 sites in the OP significantly reduced the frequency of the episodes of involuntary eyelid closure in 2 patients with AEO but not BS. The therapeutic effect lasted for 7 months after the first treatment and for 8 months after the second in a 46 year old woman with a 6 month history while the second patient (72 year old parkinsonian) has now completed her 3rd month of treatment.
Defazio
G
G
Instituto di Clinica delle Malattie Nervose e Mentali, Università di Bari.
Lepore
V
V
Lamberti
P
P
Livrea
P
P
Ferrari
E
E
D000328:Adult; D001072:Apraxias / Q000188:drug therapy*; D001764:Blepharospasm / Q000188:drug therapy*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D005141:Eyelid Diseases / Q000188:drug therapy*; D005152:Facial Muscles; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013035:Spasm / Q000188:drug therapy*; D014103:Torticollis / Q000188:drug therapy*
D001905:Botulinum Toxins