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Long-Term Efficacy of Botulinum A Toxin for Blepharospasm and Hemifacial Spasm

Published online by Cambridge University Press:  02 December 2014

Harmeet S. Gill  and
Stephen P. Kraft
Harmeet S. Gill
Affiliation:
Department of Ophthalmology and Vision Sciences, University Health Network and the University of Toronto, Toronto, Ontario, Canada
Stephen P. Kraft*
Affiliation:
Department of Ophthalmology and Vision Sciences, University Health Network and the University of Toronto, Toronto, Ontario, Canada
*
The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8Canada.
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Abstract

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Objective:

To determine whether the duration of relief from symptoms in patients with essential blepharospasm (EB) or hemifacial spasm (HFS) who receive serial treatments with botulinum toxin type A (BtA) changes over the long-term.

Methods:

Retrospective longitudinal comparative analysis. The main outcome measure is the mean duration of relief from symptoms after an injection with BtA. Participants included 34 patients who received 30 or more serial BtA treatments for facial dyskinesia (EB or HFS). Repeated measures and linear regression analyses were used to determine trends and the mean duration of relief from symptoms was compared between early (first ten effective treatments) and late (last ten treatments) sessions in each group.

Results:

In the EB group (18 patients), the mean duration of relief was 13.5 weeks for the early and 11.4 weeks for the late sessions (P=0.04). In the HFS group (16 patients) the mean duration of relief was 12.4 weeks in both treatment periods (P=0.91). The duration of relief had a small negative correlation with mean late session BtA dose in the EB group (P=0.03) but no correlation in the HFS group (P=0.12).

Conclusions:

There was a trend towards a decreased duration of relief from symptoms in patients with EB over the long-term, but no changes for HFS. The treatment remains effective in relieving symptoms and signs for both conditions.

Résumé:

RÉSUMÉ:Objectif:

Le but de l’étude était de déterminer si la durée de soulagement des symptoms chez les patients atteints de blépharospasme essentiel (BSE) ou de spasme hémifacial (SHF) qui ont reçu des traitements en série par la toxine botulique de type A (BtA) change à long terme.

Méthodes:

Il s’agit d’une etude longitudinale rétrospective. L’issue primaire était la durée moyenne de soulagement des symptômes après une injection de BtA. L’étude porte sur 34 patients qui ont reçu plus de 30 traitements en série au moyen de la BtA, pour des dyskinésies faciales (BSE ou SHF). Des mesures répétées et des analyses de régression linéaires ont été utilisées pour déterminer la tendance. La durée moyenne du soulagement des symptômes a été comparée entre les première sessions (les 10 premiers traitements efficaces) et les sessions tardives (10 derniers traitements) dans chaque groupe.

Résultats:

Dans le groupe BSE (18 patients), la durée moyenne de soulagement était de 13,5 semaines pour les premiers traitements et de 11,4 semaines pour les derniers (p = 0,04). Dans le groupe SHF (16 patients), la durée moyenne de soulagement était de 12,4 semaines au cours des deux périodes de traitement (p = 0,91). La durée du soulagement avait une faible corrélation négative avec la dose moyenne de BtAdes dernières sessions dans le groupe BSE (p = 0,03) mais pas de corrélation dans le groupe SHF (p = 0,12).

Conclusions:

Il existait une tendance à long terme vers une durée moindre du soulagement chez les patients atteints de BSE mais pas de changement chez ceux atteints de SHF. Le traitement demeure efficace pour soulager les symptômes et les signes de ces deux maladies.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 5 , September 2010 , pp. 631 - 636
Copyright
Copyright © The Canadian Journal of Neurological 2010

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