Dosage of botulinum toxin in patients undergoing treatment for hemifacial spasm: is there modification during follow-up?

IF 1 4区 医学 Q4 NEUROSCIENCES
Arquivos de neuro-psiquiatria Pub Date : 2025-01-01 Epub Date: 2025-01-15 DOI:10.1055/s-0044-1793935
Fátima de Menezes Dantas, Felipe Olobardi Freire, Agábio Diógenes Pessoa Neto, Clécio de Oliveira Godeiro Júnior, Rodrigo Alencar E Silva
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引用次数: 0

Abstract

Background:  The movement disorder known as hemifacial spasm is characterized by involuntary contractions of the muscles that are innervated by the facial nerve. The treatment of choice for this condition is botulinum toxin injections.

Objective:  To analyze the botulinum toxin dosage in patients undergoing treatment for hemifacial spasm during a 14-year period.

Methods:  A retrospective study of medical records from patients treated at the Neurology Service of Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, from 2010 to 2024, was performed.

Results:  A total of 151 patients met the inclusion criteria. The dose of botulinum toxin revealed a statistically significant increase during the first 3.46 years of follow-up. In the long-term, a trend toward dose stabilization was identified. The median latency for the onset of effect was 4 days, while the median duration of effect was 3 months. All side effects were temporary, with the most common being hemifacial weakness (17.9%) and palpebral ptosis (3.3%). Most patients presented primary hemifacial spasm (88.1%), with a neurovascular conflict identified in 24.1% of cases.

Conclusion:  The increase in botulinum toxin dosage during the first years may be explained by dosage adjustment to control hemifacial spasm with the lowest possible doses. A prolonged interval between applications may also be associated with this increase. Dose stabilization tends to be achieved over time, indicating disease control.

面肌痉挛患者肉毒毒素的用量:随访中是否有改变?
背景:运动障碍称为面肌痉挛,其特征是受面神经支配的肌肉不自主收缩。这种情况的治疗选择是注射肉毒杆菌毒素。目的:分析14年来面肌痉挛患者的肉毒毒素用量。方法:回顾性分析2010年至2024年在北格兰德联邦大学Universitário Onofre Lopes医院神经内科治疗的患者病历。结果:151例患者符合纳入标准。在前3.46年的随访中,肉毒杆菌毒素的剂量显示出统计学上显著的增加。从长期来看,确定了剂量稳定的趋势。中位起效潜伏期为4天,中位起效持续时间为3个月。所有的副作用都是暂时的,最常见的是面瘫(17.9%)和眼睑下垂(3.3%)。大多数患者表现为原发性面肌痉挛(88.1%),24.1%的病例伴有神经血管冲突。结论:头一年肉毒毒素剂量的增加可能与以尽可能低的剂量调节控制面肌痉挛有关。应用程序之间较长的间隔也可能与这种增长有关。随着时间的推移,剂量趋于稳定,表明疾病得到控制。
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来源期刊
Arquivos de neuro-psiquiatria
Arquivos de neuro-psiquiatria 医学-精神病学
CiteScore
2.10
自引率
7.10%
发文量
262
审稿时长
4-8 weeks
期刊介绍: Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology. The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.
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