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

IF 1.1 Q4 PHARMACOLOGY & PHARMACY

Current drug safety Pub Date : 2023-01-01 DOI:10.2174/1574886317666220908094404

Stefano Zoccolella, Angelo Fabio Gigante, Salvatore Misceo

{"title":"AChR+ Ocular Myasthenia and Facial Hemispasm: A Case Report of Unusual Association and Botulinum Toxic Type A Safety and Efficacy.","authors":"Stefano Zoccolella, Angelo Fabio Gigante, Salvatore Misceo","doi":"10.2174/1574886317666220908094404","DOIUrl":null,"url":null,"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.","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current drug safety","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1574886317666220908094404","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

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.

查看原文本刊更多论文

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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current drug safety PHARMACOLOGY & PHARMACY-

CiteScore

2.10

自引率

0.00%

发文量

112

期刊介绍： Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.