The Effect of Botulinum TOxin Application if Neuro-Ophthalmological Indications on the Results of Schirmer’s Test and Tear Osmolarity

Botulinum toxin type A (BT-A) is used in the treatment of neuroophthalmologic disorders such as essential blepharospasm and facial hemispasm for more than 20 years. Although the long-term effect of repeated application of the BT-A was confirmed, the BT-A effect on tears production and retention is not clear. In our work we investigated whether applied BT-A in patients with blepharospasm and hemifacial spasm affect tears production. Tears quality was measured with Schirmer’s and tear osmolarity test during neuro-ophthalmologic diseases treatment, which was evaluated before and 14 days after application of BT-A (Botox inj, Allergan, Irvine, USA) into the orbicularis oculi muscle. BT-A doses of 16-18 U with unilateral and 32 to 36 U bilateral applications were used. The mean tear production in Schirmer’s test before BT-A application was 8.38 ± 0.63 mm, and 2 weeks after BT-A application was 7.12 ± 0,6 mm (n = 50). Tear osmolarity was 305.4 ± 9.2 mOsm before BT-A application, and 2 weeks after BT-A application it was 305.2 ± 8,6 mOsm (n = 13). We found significant difference between two groups in tear quantity (p < 0.012), but not quality (p > 0.05). Application of the BT-A reduced the amount of tears measured by Schirmer’s test. These results confirm rational basis of the empirical clinical experience where an artificial tears substitution is recommended for patients with neuro-ophthalmologic disorders treated by BT-A.

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Botulinum toxin type A in the treatment of hemifacial spasm: an 11-year experience

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000400006 ◽

2010 ◽

Vol 68 (4) ◽

pp. 502-505 ◽

Cited By ~ 14

Author(s):

Egberto Reis Barbosa ◽

Leonel Tadao Takada ◽

Lilian Regina Gonçalves ◽

Rose Mary Paulo do Nascimento Costa ◽

Laura Silveira-Moriyama ◽

...

Keyword(s):

Botulinum Toxin ◽

Hemifacial Spasm ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

School Of Medicine ◽

Long Term Effect ◽

Subjective Judgement ◽

The Mean

In order to evaluate the long-term effect of botulinum toxin type A (BTX) in the treatment of hemifacial spasm (HFS), a retrospective analysis of patients treated at the Movement Disorders Unit of the Division of Neurology, Clinical Hospital, University of São Paulo, School of Medicine from 1993 to 2004 was made. A total of 808 injections with BTX were administered to 54 patients with HFS. The mean duration of improvement per application was 3.46 months and the mean rate of improvement using subjective judgement by the patient was of 83%. Adverse effects, mostly minor, were observed in 64.8% of patients at least once along the period of follow-up and the most frequent of them was orbicularis oris paralysis (38.8%). There was no decrement in response when compared the first and the last injection recorded.

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Botulinum toxin A in the treatment of blepharospasm: a 10-year experience

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000200006 ◽

2005 ◽

Vol 63 (2a) ◽

pp. 221-224 ◽

Cited By ~ 18

Author(s):

Laura Silveira-Moriyama ◽

Lilian R. Gonçalves ◽

Hsin Fen Chien ◽

Egberto R. Barbosa

Keyword(s):

Botulinum Toxin ◽

Adverse Effects ◽

Botulinum Toxin A ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Term Effect ◽

Secondary Resistance ◽

School Of Medicine ◽

Long Term Effect

To evaluate the long-term effect of botulinum toxin type A (BTX) in the treatment of blepharospasm, a retrospective analysis was conducted from the patients seen at the Movement Disorders Clinic of the Department of Neurology, Hospital das Clínicas, University of São Paulo School of Medicine from 1993 to 2003. A total of 379 treatments with BTX were administered to 30 patients with blepharospasm. Sixty six per cent of the subjects had used oral medication for dystonia and only 15% of them reported satisfactory response to this treatment. Ninety three per cent of the patients showed significant improvement after the first BTX injection. There was no decrement in response when compared the first and the last injection recorded. Adverse effects, mostly minor, developed at least once in 53% of patients. Six patients (20%) discontinued the treatment but there was no case of secondary resistance.

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

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100010817 ◽

2010 ◽

Vol 37 (5) ◽

pp. 631-636 ◽

Cited By ~ 22

Author(s):

Harmeet S. Gill ◽

Stephen P. Kraft

Keyword(s):

Hemifacial Spasm ◽

Repeated Measures ◽

Outcome Measure ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Essential Blepharospasm ◽

The Mean ◽

Symptoms And Signs ◽

Facial Dyskinesia

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.

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Outcome of Injection Botulinum Toxin in Blepharospasm

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.30589 ◽

2021 ◽

Vol 13 (1) ◽

pp. 40-49

Author(s):

Malita Amatya ◽

Ben Limbu ◽

Purnima Rajkarnikar ◽

Hom Bahadur Gurung ◽

Rohit Saiju

Keyword(s):

Botulinum Toxin ◽

Hemifacial Spasm ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Line Treatment ◽

First Line ◽

Essential Blepharospasm ◽

Meige Syndrome ◽

The Mean ◽

First Line Treatment

Introduction: Blepharospasm is a condition of involuntary spasm of the orbicularis oculi muscle which leads to intermittent or complete closure of the eyelids. Botulinum toxin is the currently recommended first line treatment for such blepharospasm. This study aims to find out the outcome of injection Botulinum toxin Type A in Blepharospasm. Materials and methods: It was a hospital based, prospective, interventional study conducted on patients diagnosed as Benign essential blepharospasm (BEB), Meige syndrome (MS) and Hemifacial spasm (HFS) by oculoplastic surgeon at Oculoplasty department OPD, Tilganga Institute of Ophthalmology, from December 2018 to November 2019. After taking all standard precautions for botulinum toxin injections, 6 to 8 sites for injecting 2.5 to 5 IU of the toxin were given. All the patients were evaluated before and after injections according to Jankovic spasm grading and improvement in functional impairment scale and followed on one week, one month, three month and when the symptoms reappeared. Results: A total of 43 cases which included 32 cases of Benign essential Blepharospasm, 9 Hemifacial spasm and 2 Meige syndrome. The mean Jankovic severity score was 3.51 ± 0.51 (range 3-4). The mean improvement in functional score was 2.60 ± 0.54 (range 1-3), was statistically significant (p-value <0.001).The effective period of injection was 130 ± 20.82 (93 – 189) days.38 patients had repeated injections after reappearance of symptoms. 4 patients had side effects of redness and hematoma at one site. Conclusion: This study concludes that Botulinum toxin type A is effective in the management of Benign essential blepharospasm, Hemifacial spasm and Meige syndrome. This along with a good safety profile justifies its role as a first line treatment therapy in blepharospasm. However, it is a temporary treatment option where the effect lasts for a short period of time and repeated injections are required.

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Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160191 ◽

2017 ◽

Vol 75 (2) ◽

pp. 87-91 ◽

Cited By ~ 10

Author(s):

Jean Pierre Mette Batisti ◽

Alais Daiane Fadini Kleinfelder ◽

Natália Bassalobre Galli ◽

Adriana Moro ◽

Renato Puppi Munhoz ◽

...

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Hemifacial Spasm ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Term Effect ◽

Long Term Effect

ABSTRACT Hemifacial spasm (HFS) is a common movement disorder characterized by involuntary tonic or clonic contractions of the muscles innervated by the facial nerve. Objective To evaluate the long-term effect of botulinum toxin type A (BTX-A) in the treatment of HFS. Methods A retrospective analysis of patients treated at the Movement Disorders Outpatient Clinic in the Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, from 2009 to 2013 was carried out. A total of 550 BTX-A injections were administered to 100 HFS patients. Results Mean duration of improvement following each injection session was 3.1 months, mean latency to detection of improvement was 7.1 days and mean success rate was 94.7%. Patients were evaluated at an interval of 5.8 months after each application. Adverse effects, which were mostly minor, were observed in 37% of the patients at least once during follow-up. The most frequent was ptosis (35.1%). Conclusion Treatment of HFS with BTX-A was effective, sustainable and safe and had minimal, well-tolerated side effects.

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