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目的 观察单侧面肌痉挛 (HFS)的A型肉毒毒素 (BTXA)治疗效果 ;探讨治疗前后双刺激瞬目反射 (BR)检测的意义。方法 对 134例患者进行BTXA局部肌肉注射 ,其中 42例治疗前后行BR检测。结果 134例患者中 ,症状完全缓解 6 0例 ,占 44 8% ,明显改善 74例 ,占 5 5 2 %。疗效持续时间 (16 5± 5 7)周。42例患者治疗前患侧BR检测 ,R1、R2 、R’2 潜伏期正常 ,R2 间期缩短 ,R1、R2 、R’2 振幅增高。治疗后复查 ,其中R1消失者 7例 ,R1、R2 、R’2 均消失者 5例 ,余 30例R1、R2 、R’2 潜伏期稍延长 ,但差异无显著意义 ;R1、R2 、R’2 波幅明显降低 (P <0 0 5 )。结论 BTXA治疗HFS疗效显著 ,是首选疗法 ;双刺激BR检测表明 ,患者脑干中间神经元兴奋性升高。
Objective To observe the therapeutic effect of botulinum toxin type A (BTXA) with unilateral hemifacial spasm (HFS) and to explore the significance of double stimulus (BR) detection before and after treatment. Methods One hundred and thirty-four patients underwent local intramuscular injection of BTXA, 42 of whom underwent BR testing before and after treatment. Results In 134 patients, the symptoms were completely relieved 60 cases, accounting for 44.8%, 74 cases were significantly improved, accounting for 52.2%. Duration of efficacy (16 5 ± 5 7) weeks. Forty-two patients had ipsilateral BR test before treatment, R1, R2, R’2 latency was normal, R2 interval shortened, R1, R2, R’2 amplitude increased. After treatment, there were 7 cases with disappearance of R1, 5 cases with disappearance of R1, R2 and R’2, and a slightly longer latency of R1, R2 and R’2 in the remaining 30 cases, but the difference was not significant. R1, R2, R ’ 2 amplitude decreased significantly (P <0 05). Conclusions BTXA has a significant curative effect on HFS and is the first choice of therapy. The double stimulation BR test shows that the excitability of middle cerebral neurons in patients is increased.