AChR+ Ocular Myasthenia and Facial Hemispasm: A Case Report of Unusual Association and Botulinum Toxic Type A Safety and Efficacy.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.2174/1574886317666220908094404

Stefano Zoccolella, Angelo Fabio Gigante, Salvatore Misceo

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引用次数: 0

Abstract

Introduction: Hemifacial spasm represents segmental myoclonus of muscles innervated by the facial nerve, which is usually and successfully treated with botulinum toxin. Botulinum toxin (BTX) acts as an acetylcholine release inhibitor at presynaptic cholinergic junctions and therefore is considered contraindicated (or administrable with caution) in patients with neuromuscular disorders like Myasthenia Gravis (MG). Moreover, to date, the association of hemifacial spasm and ocular MG is extremely rare and only a few cases have been described.

Case presentation: We report the case of a 73 years old man with a 3-year history of ocular MG who developed a left hemifacial spasm. The patient underwent hemispasm, treatment with BTX type A (abobotulinum toxin-A, total dose of 50 IU) that resulted in safe and successful 6 months re-evaluation.

Conclusion: Our results suggest that in selected cases with concomitant MG and conditions characterized by orbicularis oculi spasms or hemispasm, BTX therapy may not be contraindicated and could be given at longer intervals due to prolonged effects.

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AChR+眼性重症肌无力和面部半瘫1例:异常关联与A型肉毒杆菌中毒的安全性和有效性。

面肌痉挛是面神经支配的肌肉的节段性肌阵挛，通常用肉毒杆菌毒素治疗。肉毒杆菌毒素(BTX)作为突触前胆碱能连接的乙酰胆碱释放抑制剂，因此被认为是神经肌肉疾病如重症肌无力(MG)患者的禁忌症(或谨慎用药)。此外，到目前为止，面肌痉挛和眼MG的关联是极其罕见的，只有少数病例被描述。病例介绍:我们报告一位73岁的男性，有3年的眼部MG病史，并发左半面肌痉挛。患者接受了半半球治疗，BTX A型(肉毒杆菌毒素-A，总剂量为50 IU)导致安全成功的6个月重新评估。结论:我们的研究结果表明，在选择的伴有MG和以眼轮匝肌痉挛或半痉挛为特征的病例中，BTX治疗可能不是禁忌症，由于效果较长，可以延长间隔时间。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.