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DOI:10.3969/j.issn.1009-6574.2017.03.006
Clinical and therapeutic features of patients with hemifacial spasm and benign essential blepharospasm
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Abstract:
Objective  To confirm the clinical features and therapeutic efficacy of botulinum toxin type A(BTX-A)for hemifacial spasm(HFS) and benign essential blepharospasm(BEB) patients. Methods  Totals of 110 HFS patients and 90 BEB patients from Department of Neurology,Renmin Hospital of Wuhan Universitybetween April 2013 and October 2013 were included in this cross-section study. All patients were instructedto be reviewed in the second week after BTX-A injection. The duration of effects of BTX-A injection was re-corded. Results (1) Of 200 patients who were included,the mean duration was 61.6 months. The onset time was 0-30 d (median 4 d). The duration of response was 2-128 weeks (median 16 weeks). Of all patients,the effective rate was 96.9%,while 99.3% for HFS patients and 90.2% for BEB patients. Patients with HFS received a lower mean dose of BTX than patients with BEB [(53.2±15.8)U vs (74.8±20.2)U]. And patients with HFS had a longer treatment duration than patients with BEB[(20.3±10.2)weeks vs (13.6±5.5)weeks]. (2) BTX-A injection was the most commonly used treatment (70.9%),followed by acupuncture (68.2%) and oral medication (65.5%) inHFS patients. Most patients gave up acupuncture and oral medication because of the ineffectiveness. In BEB patients,BTX-A injection was the most commonly used treatment (88.9%),followed by oral medication (86.7%) and orbicu-laris oculi myectomy (31.3%),whereas orbicularis oculi myectomy was not effective. Conclusions HFS and BEB are most common diseases in movement disorder clinic. BTX-A treatment is safe and effective for both BEB and HFS,with better effect for HFS. BEB patients require more frequent injections,highlighting that facial dystonia in patients with BEB is more challenging to manage.
Key words:  Botulinum toxins,type A  Hemifacial spasm  Benign essential blepharospasm  Treatment

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