Preventing ptosis after botulinum treatment.
In a series of 33 blepharospasm patients who had the side effect of ptosis following therapeutic botulinum toxin type A (Botox: Allergan, Inc., Irvine, CA, U.S.A.) injection, we administered 41 injections of human botulinum immune globulin (IG) following injections of the toxin to test the dosage and timing of IG injection and its effectiveness in limiting or avoiding ptosis. An IG dose of 3.2 x 10(-3) international units (IU) per unit of Botox was effective in blocking toxin effect when injected into the same tissue site within 4 hours. An IG dose of 1.6 x 10(-2) to 3.2 x 10(-2) into the levator of the eye having more frequent ptosis in 19 patients reduced the incidence of ptosis to 11%. The fellow (control) eye had a ptosis incidence of 37%. No orbital hemorrhage or other adverse effect occurred from the IG or its injection.
Scott
A B
AB
Smith-Kettlewell Eye Research Institute, San Francisco, California 94115, USA.
D000818:Animals; D001763:Blepharoptosis / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D001764:Blepharospasm / Q000628:therapy*; D001904:Botulinum Antitoxin / Q000008:administration & dosage / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D004305:Dose-Response Relationship, Drug; D004576:Electromyography; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use; D007273:Injections, Intramuscular; D051379:Mice; D009465:Neuromuscular Agents / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D009801:Oculomotor Muscles / Q000187:drug effects / Q000503:physiopathology; D012449:Safety; D016896:Treatment Outcome
D001904:Botulinum Antitoxin; D007074:Immunoglobulin G; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A