Botulinum A Toxin Treatment of Hemifacial Spasm: The Dose-response Relationship in Orbicularis Oculi

J Korean Neurol Assoc > Volume 10(2); 1992 > Article

Journal of the Korean Neurological Association 1992;10(2): 155-161.

편측안면경련의 보튤리눔 A독소 치료시 안륜근에서의 용량 - 반응 관계에 대한 조사

위봉애, 이광우,명호진,김주용,노재규,홍승봉,김상윤,나정호,이일근,이재홍,박?성호,이상복,정진상

서울대학교 신경과. 충남대학교 신경과.

Botulinum A Toxin Treatment of Hemifacial Spasm: The Dose-response Relationship in Orbicularis Oculi

Bong-Ae Wie, M.D., Kang-Woo Lee, M.D., Hojin Myung, M.D., Joo-Yong Kim, M.D., Jae-Kyu Roh, M.D., Seung-Bong Hong, M.D., Sang-Yun Kim, M.D., Joung-Ho Rha, M.D., Il-Keun Lee, M.D., Jae-Hong Lee, M.D., Seong-Ho Park, M.D., Sang-Bok Lee, M.D., Chin-Sang Chung

Department of Neurology, College of Medicine, Seoul National University. Department of Neurology, College of Medicine, Chungnam National Universtiy

Abstract

Forty-one patients with hemifacial spasm received botulinum A toxin in total 73 visits. In 68 of 73 visits(93%), substantial improvement with peak effect(change in severity of hemifacial spasm 22 ) was obtained, with a mean total dose of 12.5 units. Mean severity of hemifacial spasm before and after treatrnent were 3.8 and 1.1 respectively on a 0-5 scale. Mean muscle dose of orbicularis oculi was 9.0 units There was a significant association between muscle dose and post-treatment weakness of orbicularis oculi(Spearman correlation coefficient, 0.42691). There was also a striking and significant association between post-treatment weakness of orbicularis oculi and peak effect(Spearman correlation coefficient, 0.74883). Lagophthalmos occurred only in 2 of 28 visits (7%) who received lesser than 10.0 units for orbicularis oculi as compard to 22% in the higher dose group. But peak effects showed no significant difference between the two groups(p =O.I30). We suggest that the occurrence of lagophthalmos can be reduced with the dose lesser than 10.0 units for orbicularis oculi, maintaining the significant effect.