The Effectiveness To HFS And The Influence To Facial Never's CMAP By Long-term Repeat BTX Injection

1. The effectiveness and safety to HFS by long-term repeat BTX injection.Objective:To observe the effctiveness and safety of long-term repeat BTX injection for HFS.Methods: 48 patients with hemifacial spasm were divided into two groups based on the times of the patients had received BTX injection:first BTX injection group(30 patients) and long-term repeat BTX injection group(received 4 times BTX injection or more consecutively)(18 patients).following up 6 monthes visit,to compare the time of clinical effect begains,the times of reach the maximum therapeutic effect ,the grade and the duration of the effect within the two groups.Results: There were no difference in the time of effect begains between the two groups,the time of reach the maximum therapeutic effct,the grade and the duration of the effect.Conclusion: The effectiveness to HFS by long-term repeat BTX injection is still prominent,and the time of effect begains,the time of reach the maximum therapeutic effct,the grade and the duration of the effect still keep sustained.2. The influence to facial never's CMAP by long-term repeat BTX injection.Objective:To investigate the influence to facial nerve's CMAP by long-term repeat BTX injection.Methods:44 patients with hemifacial spasm were divided into three groups based on the course of the disease and the times patient received BTX-A injection:short term group(20 patients), long-term without BTX-A injection group(10 patients) and long-term repeat BTX-A injection group(18 patients). The examination of the latency and amplitude of facial never were determined with EMG before this BTX-A injection to investigate the function of facial never.1.Comepare the facial nerver's latency and amplitude of the two side within short term group and long-term without BTX-A injection group,and comepare the facial nerver's latency and amplitude of the affected side between the two groups, in order to determine if HFS can influence the latency and amplitude of the facial nerver or not,even determine the baseline of the facial nerver's latency and amplitude of the two groups. 2. Monitor the change of the facial nerver's CMAP of 7 patients who received BTX-A injection for the first time at before and after BTX-A injection,in order to determine the blockage of BTX-A to facial nerve.3.Comepare the facial nerver's latency and amplitude of the two side within long-term without BTX injection group and long-term repeat BTX-A injection group,and comepare the facial nerver's latency and amplitude of the affected side between the two groups,in order to determine the influence to facial never's CMAP by long-term repeat BTX injection.Results:1.There were no significant difference in the facial nerver's latency and amplitude of the two side within the short term group and long-term without BTX injection groups,and the same to the affected side between the two groups. 2. A significant decrease of facial nerver's amplitude was observed at 1 week,2 week,1 month,3 month after BTX-A injection,comeparing with before BTX-A injection.and a significant extend of facial nerver's latency was also observed at 1 week,2 week,1 month after BTX-A injection. 3. There were no significant difference in the affected facial nerver's latency of long-term repeat BTX-A injection group, comeparing with the unaffected side and the affected side of long-term without BTX-A injection group.But there were significant decrease in the affected facial nerver's amplitude of long-term repeat BTX-A injection group, comeparing with the unaffected side and the affected side of long-term without BTX-A injection group.Conclusion:1.We found that the facial nerve's CMAP was not influented in HFS patients,even in long-term HFS patients.2. BTX-A can markly block the facial nerve:the facial nerver's amplitude was significant decreased and the facial nerver's latency was markly delayed after BTX-A injection.But this is a reversible procedure:the latency recover to norma baseline at 3 month after BTX-A injection,but the amplitude need 6 month to recover normal.3.After long-term repeat BTX-A injection,the facial nerve's latency can recover normal on time,but the recovery of facial nerver's amplitude need more time.