Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated

Jean Pierre Mette Batisti; Alais Daiane Fadini Kleinfelder; Natália Bassalobre Galli; Adriana Moro; Renato Puppi Munhoz; Hélio Afonso Ghizoni Teive

doi:10.1590/0004-282X20160191

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(02): 87-91
DOI: 10.1590/0004-282X20160191

ARTICLES

Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated

Tratamento do espasmo hemi-facial com toxina botulínica tipo a foi efetivo, bem tolerado e com efeito sustentado

Jean Pierre Mette Batisti

¹Universidade Federal do Paraná, Hospital de Clínicas, Curitiba PR, Brasil;

,

Alais Daiane Fadini Kleinfelder

¹Universidade Federal do Paraná, Hospital de Clínicas, Curitiba PR, Brasil;

,

Natália Bassalobre Galli

¹Universidade Federal do Paraná, Hospital de Clínicas, Curitiba PR, Brasil;

,

Adriana Moro

²Universidade Federal do Paraná, Hospital de Clínicas, Unidade de Distúrbios do Movimento, Departamento de Medicina Interna, Serviço de Neurologia, Curitiba PR, Brasil;

,

Renato Puppi Munhoz

³University Health Network, Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson’s Disease, Toronto Western Hospital, Toronto, Ontario, Canada.

,

Hélio Afonso Ghizoni Teive

²Universidade Federal do Paraná, Hospital de Clínicas, Unidade de Distúrbios do Movimento, Departamento de Medicina Interna, Serviço de Neurologia, Curitiba PR, Brasil;

› Author Affiliations

Abstract

ABSTRACT

Hemifacial spasm (HFS) is a common movement disorder characterized by involuntary tonic or clonic contractions of the muscles innervated by the facial nerve.

Objective

To evaluate the long-term effect of botulinum toxin type A (BTX-A) in the treatment of HFS.

Methods

A retrospective analysis of patients treated at the Movement Disorders Outpatient Clinic in the Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, from 2009 to 2013 was carried out. A total of 550 BTX-A injections were administered to 100 HFS patients.

Results

Mean duration of improvement following each injection session was 3.1 months, mean latency to detection of improvement was 7.1 days and mean success rate was 94.7%. Patients were evaluated at an interval of 5.8 months after each application. Adverse effects, which were mostly minor, were observed in 37% of the patients at least once during follow-up. The most frequent was ptosis (35.1%).

Conclusion

Treatment of HFS with BTX-A was effective, sustainable and safe and had minimal, well-tolerated side effects.

RESUMO

O espasmo hemifacial (EHF) é um distúrbio do movimento comum, caracterizado pela presença de contrações musculares tçnicas ou clçnicas dos músculos inervados pelo nervo facial.

Objetivo

Avaliar o efeito em longo prazo do uso da toxina botulínica tipo A (TXB) no tratamento do espasmo hemifacial (EHF).

Métodos

Foi realizada uma análise retrospectiva de pacientes do Ambulatório de Distúrbios do Movimento do departamento de Neurologia do Hospital das Clínicas da Universidade Federal do Paraná entre 2009 e 2013. Foram administradas 550 doses em 100 portadores de EHF.

Resultados

A duração média de efeito foi de 3,14 meses, com latência de 7,10 dias e a taxa de sucesso foi de 94,73%. Os pacientes foram reavaliados pelo médico em um intervalo de 5,76 meses após cada aplicação. Efeitos adversos transitórios, em sua maioria menores, foram observados em 37% dos pacientes ao menos uma vez durante o seguimento e o mais freqüente foi ptose palpebral (35,14%).

Conclusão

O tratamento do EHF com TXB-A mostrou-se eficaz, sustentado e seguro, com efeitos colaterais mínimos e bem tolerados.

botulinum toxins - botulinum toxin type A - hemifacial spasm

toxinas botulínicas - toxina botulínica tipo A - espasmo hemifacial

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References

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