The Study Of The Influence Of Electrophy Siology Of Hemifacial Spasm By Repeated Injection Of Botulinum Toxin Type A

Objectives:To investigate the influence of botulinum toxin type A injection forhemifacial spasm patients on facial nerve and and brainstem function, and evaluate theeffectiveness and safety of hemifacial hemifacial spasm patients. who receive manytreatments with botulinum toxin type A.Methods:Select the patients who receive botulinum toxin type A regular regularly inoutpatient of Neurology Department of Affiliated Hospital of Dalian MedicalUniversity from July2012to February2013. Total18cases, including5males and13females, aged from29to77years, a mean age of59.33±13.54years, duration of HFSfrom4-29years, a mean duration of HFS for9.5±10.25years, left side have11patients, the right side have7patients,18cases were accepted botulinum toxininjection, the number of injections from5to15times,an average of11.33±4.30times, the interval to the last injection time is7.53±2.27months.18cases of HFS patients with many times of the botulinum toxin injection，Compare their CMAP、blink reflex between affected side and healthy side beforetreatment；Compare their CMAP、blink reflex of affected side and healthy sidebetween before and after treatment；TO Clear find out whether botulinum toxin willaffect the function of peripheral nerve and brainstem.In accordance with the number times of injections,18patients were dividedinto repeated BTXA with less times group(5times <botulinum toxin treatment times≤10times) and repeated BTXA with more times group (botulinum toxin treatment times>10times). Compare the difference of CMAP before and after treatment andthe difference of amplitude of the blink before and after treatment. To find out whether the increased frequency of BTXA injection will increase the impacton onperipheral nerve and brainstem function. Compare two groups of the injecteddose, onset time, duration, and the occurrence rate of side effects, drug efficacy. To findout whether the times of injection have impact on clinical efficacy of BTXA.Results:18patients after treatment, complete remission rate is67%, the significantlyresponse rate is33%, partial remission rate is0, ineffective rate is0. Efficiencyis100%(complete remission rate+significantly remission rate+partial response rate).Compare bilateral CMAP、R1、 R2、R2’ of18patients before treatment: thelatency,and amplitude of healthy side and the affected side have no significantStatistical difference. Affected side of1patient had no R1response.Compare Blink reflex and CMAP of18patients before and after treatment:the CMAP、R1、R2、R2’ amplitude of affected side after treatment compared withbefore treatment is reduced。There were Statistically significant difference（P＜0.05）。CMAP, R1, R2amplitude of healthy side were no Statistically significant differencebefore and after treatment（P＞0.05）。CMAP, R1, R2latency of healthy side andaffected side were no Statistically significant difference before and after treatment（P＞0.05）。There is no R1in1patient separately before and after treatment.The Injection interval time, injected dose, onset time, duration, the occurrencerate of side effects, drug efficacy were not statistically significant different betweenrepeated BTXA with less times group and repeated BTXA with more times group(P>0.05). There is side effect which is facial paralysis in2patient in each group, astime goes on, it can return to normal. The decreased difference ofCMAP, R1, R2, R2’amplitude before and after treatment in both groups was noStatistically significant differenceConclusions:1、 BTX-A injection can significantly improve the clinicalsymptoms of patients with hemifacial spasm2、 BTX-A injection can reduce the excitability of facial nerve of hemifacialspasm, and does not affect the conduction function3、 BTX-A injection can reduce excitability of the brainstem intern neuronal ofhemifacial spasm4、 Repeated injection of botulinum toxin type A don’t aggravate the impact of the facial nerve and brainstem function...