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Espasmo hemifacial bilateral: relato de caso
Machado Flavia Costa Nunes,Fregni Felipe,Campos Cynthia Resende,Limongi Jo?o Carlos Papaterra
Arquivos de Neuro-Psiquiatria , 2003,
Abstract: Espasmo hemifacial bilateral é um distúrbio de movimento raro geralmente associado à compress o vascular dos nervos faciais. Caracteriza-se clinicamente por contra es assimétricas e assíncronas da musculatura facial e por longa latência entre a instala o dos movimentos em cada hemiface. Deve ser diferenciado de outras condi es como blefaroespasmo, miocimia facial, tiques faciais, distonia oromandibular e espasmo hemimastigatório. O tratamento sintomático mais eficaz e menos invasivo consiste em aplica es de toxina botulínica mas abordagem cirúrgica de descompress o microvascular é outra alternativa terapêutica. Relatamos o caso de homem de 70 anos com espasmo hemifacial bilateral e fazemos uma breve revis o da literatura.
Blefarospasmo essencial e espasmo hemifacial: características dos pacientes, tratamento com toxina botulínica A e revis o da literatura  [cached]
Schellini Silvana Artioli,Matai Olívia,Igami Thais Zamudio,Padovani Carlos Roberto
Arquivos Brasileiros de Oftalmologia , 2006,
Abstract: OBJETIVO: Conhecer as características dos portadores de blefarospasmo essencial e espasmo hemifacial, assim como a resposta ao tratamento utilizando toxina botulínica A. MéTODOS: Trinta e quatro portadores de blefarospasmo essencial ou espasmo hemifacial foram avaliados quanto a idade, sexo, queixas oculares, tempo de existência da doen a, tipo de comprometimento, complica es e resultado do tratamento com toxina botulínica A. RESULTADOS: A mediana da idade dos pacientes foi de 63 anos e a média, de 61 anos, sem diferen a quanto ao sexo; 66,66% possuíam espasmo hemifacial e 33,33%, blefarospasmo essencial. Vários pacientes apresentavam também olho seco. A melhora com a utiliza o da toxina botulínica A ocorreu em 91,30% dos pacientes tratados. As complica es com o tratamento foram ptose palpebral (8,33%) e desvio da rima bucal (8,33%). CONCLUS O: O blefarospasmo essencial e o espasmo hemifacial geralmente acometem idosos, de ambos os sexos. O tratamento com a toxina botulínica A é eficiente, com índice muito baixo de complica es.
Toxina botulínica no blefaroespasmo, no espasmo hemifacial e na distonia cervical: resultados em 33 pacientes
Novis, Sérgio Ap.;Mattos, James Pitágoras de;Rosso, Ana Lúcia Zuma de;
Arquivos de Neuro-Psiquiatria , 1995, DOI: 10.1590/S0004-282X1995000300006
Abstract: the effects of botulinum toxin type a were studied in 33 patients with dystonia (12 blepharospasms, 10 hemifacial spasms and 11 spasmodic torticollis). a rate scale was used to evaluate the severity of the dystonic movements, before and two weeks after each injection. among blepharospasm patients, eight were female and four were male; the mean age was 57.7 years; the mean time of the disease duration was four years. three had familial history for similar disease; nine were essential and three had used neuroleptic drugs (tardive dystonia). the mean dose used was 51.3 u, with a mean time of benefical effects of 2.8 months. for 22 injections and reinjections, 14 (63.7%) showed an excellent result, five (22.7%) good and three (13.6%) null. in the hemifacial spasm group, eight were female and two male; the mean age was 52.6 years; the mean time of the disease duration was 7.4 years; eight were essential and two post-paralytic. the mean dose used was 32 u. from the total of 15 injections and reinjections, all of them (100%) had an excellent result, with a mean time of benefical effect of 3.4 months. among the cervical dystonic patients, eight were male and three female; the mean age was 44.2 years; the mean time of the disease duration was 12.2 years; six had essential dystonia, three had used neuroleptic drugs and two had familial history for similar disease. the mean dose used was 238.6 u, with the mean duration of effect of 3.5 months. from the total of 20 injections and reinjections, 18 (90%) had good result, one (5%) mild and one (5%) null. ptosis, facial palsy and dysphagia were the most common side effects seen. we conclude that botulinum toxin is effective for the treatment of such disorders.
Custos e eficácia da toxina botulínica tipo A no tratamento do blefaroespasmo essencial e espasmo hemifacial
Lasalvia, Cintia Gomes Galv?o;Pereira, Luciano de Sousa;Cunha, Marcos Carvalho da;Kitadai, Silvia Prado Smit;
Arquivos Brasileiros de Oftalmologia , 2006, DOI: 10.1590/S0004-27492006000500016
Abstract: purpose: to evaluate the costs and efficacy of type a botulinum toxin in the treatment of essential blepharospasm and hemifacial spasm. methods: pacients with essential blepharospasm and hemifacial spasm had their files analyzed. all patients were treated with type a botulinum toxin (dysport?) between april 2002 and may 2004 at the oculoplastic clinics of "santa casa de s?o paulo". twenty-seven patients presented essential blepharospasm and 23 presented hemifacial spasm. information about the patient's degree of satisfaction after treatment, complaints and personal costs were recorded by a questionnaire, and information about the costs of dysport? treatment were obtained at the administration department of "santa casa de s?o paulo". wilcoxon and mann-whitney tests were used for statistical analysis. results: 1- the annual treatment costs were r$ 1,239.32 for essential blepharospasm and r$ 661.72 for hemifacial spasm. 2- the patient's annual costs were r$ 145.48 for essential blepharospasm and r$ 6.07 for hemifacial spasm. 3- the hospital's annual costs for the treatment were r$ 1,095.84 for essential blepharospasm and r$ 535.65 for hemifacial spasm. 4- dysport? treatment is successful in both essential blepharospasm and hemifacial spasm. conclusions:. the costs of essential blepharospasm and hemifacial spasm treatment with dysport? are high, mainly because of the toxin price. on economic analysis of health, we can conclude that this procedure has an excellent cost-benefit ratio.
Avalia o da fenda palpebral após aplica o de toxina botulínica tipo A em pacientes com distonias faciais Evaluation of palpebral fissure after botulinum toxin type A injection in patients with facial dystonias  [cached]
Mariana Eleonora Pereira Cunial,Nilson Lopes da Fonseca Junior,José Ricardo Carvalho Lima Rehder
Revista Brasileira de Oftalmologia , 2012,
Abstract: OBJETIVO: Avaliar a medida da fenda palpebral em pacientes com blefaroespasmo essencial benigno (BEB) e espasmo hemifacial (EHF) após a aplica o periocular de toxina botulínica tipo A. MéTODOS: Foram estudados pacientes portadores de BEB e EHF submetidos à inje o periocular de toxina botulínica tipo A pela técnica inner orbital de aplica o. Os pacientes foram fotografados em PPO antes da aplica o e catorze dias depois dela. A fenda palpebral foi mensurada nestas imagens por meio de processamento computadorizado de imagens, utilizando o programa ImageJ. As altera es da fenda palpebral foram observadas comparando-se as medidas obtidas no pré e pós-aplica o. RESULTADOS: Comparando-se as imagens obtidas com o programa ImageJ, houve aumento estatisticamente significante (p<0,001) da fenda palpebral em 14 olhos (51,8%) após a aplica o de inje o periocular da toxina botulínica e nenhuma das imagens analisadas apresentou diminui o da fenda palpebral. CONCLUS O: No presente estudo, os pacientes portadores de distonias faciais apresentaram aumento de fenda palpebral estatisticamente significante após aplica o periocular de toxina botulínica tipo A. PURPOSE: To evaluate the measurement of palpebral fissure in patients with facial dystonias before and after periocular injection with botulinum toxin type A. METHODS: We studied patients with benign essential blepharospasm and hemifacial spasm underwent periocular injection of botulinum toxin type A by the inner orbital technique of application. Patients were photographed 14 days before and after application. The palpebral fissure was measured in these images by means of computerized image processing using the program ImageJ. The palpebral fissure changes were observed by comparing the measurements obtained before and after application. RESULTS: Comparing the images obtained with the program ImageJ, there was a statistically significant increase (p <0.001) of the palpebral fissure in 14 eyes (51,8%) after the application of periocular injection of botulinum toxin and the images analyzed showed no decrease of the palpebral fissure. CONCLUSION: In this study, patients with facial dystonias showed increased palpebral fissure periocular statistically significant after application of botulinum toxin type A.
Blefarospasmo essencial e espasmo hemifacial: características dos pacientes, tratamento com toxina botulínica A e revis?o da literatura
Schellini, Silvana Artioli;Matai, Olívia;Igami, Thais Zamudio;Padovani, Carlos Roberto;Padovani, Carlos Pereira;
Arquivos Brasileiros de Oftalmologia , 2006, DOI: 10.1590/S0004-27492006000100005
Abstract: purpose: to evaluate the characteristics of the essential blepharospasm and hemifacial spasm patients and the feasible treatment with botulinum toxin a. methods: thirty-four essential blepharospasm or hemifacial spasm patients were evaluated according to gender, ocular complaint, time of disease, treatment outcome and complications. results: age median was 63 years and the mean was 61 years, with no difference regarding sex; 66.66% of the patients had hemifacial spasm and 33.33%, essential blepharospasm. many patients complained of dry eye associated with involuntary spasm. botulinum toxin a showed a positive outcome in 91.30% of the treated patients and complications observed after treatment were eyelid ptosis (8.33%) and buccal angle deviation (8.33%). conclusion: essential blepharospasm and hemifacial spasm occurred in the elderly, of both sexes. treatment with botulinum toxin a was useful, with very low complication rates.
Espasmo hemifacial familiar: relato de dois casos  [cached]
BARBOSA EGBERTO REIS,COSTA MARIA DO DESTERRO L. DA,STAUT CLáUDIO C.,BACHESCHI LUIZ ALBERTO
Arquivos de Neuro-Psiquiatria , 1998,
Abstract: Os autores relatam os achados clínicos e angiográficos de dois casos de espasmo hemifacial familiar. Esta é a quinta descri o sobre esse tema na literatura e apresenta m e e filha com idades de 76 e 51 anos respectivamente, nas quais o lado esquerdo foi o acometido. Exames de angiorressonancia realizados nas pacientes revelaram dolicobasilar com origem lateralizada à esquerda para ambos os casos. Também demonstraram artéria cerebelar póstero-inferior muito desenvolvida e irregularidades murais nas artérias vertebrais e basilar sugestivas de arteriosclerose na m e e vasos intracranianos levemente alongados na filha. Dados de revis o da literatura e sobre a etiologia do espasmo hemifacial s o enfocados.
Espasmo hemifacial familiar: relato de dois casos
BARBOSA, EGBERTO REIS;COSTA, MARIA DO DESTERRO L. DA;STAUT, CLáUDIO C.;BACHESCHI, LUIZ ALBERTO;BITTAR, MIRIAM SALVATORI;
Arquivos de Neuro-Psiquiatria , 1998, DOI: 10.1590/S0004-282X1998000100018
Abstract: the authors report the clinical and angiographical findings of two cases of familial hemifacial spasm. this is the fifth description in the literature and presents mother and daughter at the ages of 76 and 51 respectively, in whom the left side was affected. they underwent exams of angioresonance that showed dolichobasilar with left side origin in both patients. the exams also demonstrated postero-inferior cerebellar artery very developed and irregularities in the walls of the vertebral and basilar arteries suggestive of arteriosclerosis in the mother and slightly elongated intracranial vessels in the daughter. literature review and etiology data of the hemifacial spasm are focused.
Espasmo hemifacial bilateral: relato de caso
Machado, Flavia Costa Nunes;Fregni, Felipe;Campos, Cynthia Resende;Limongi, Jo?o Carlos Papaterra;
Arquivos de Neuro-Psiquiatria , 2003, DOI: 10.1590/S0004-282X2003000100023
Abstract: bilateral hemifacial spasm (bhs) is a rare focal movement disorder often associated with vascular compression of both facial nerves. the contractions are usually asymmetric and asynchronous. typically, one side is affected first and there is a long but variable interval for the symptoms on the other side to occur. bhs must be differentiated from other conditions including blefarospasm, facial myokymia, facial tics, oromandibular dystonia, and hemimasticatory spasm. the most successful and non-invasive symtomatic treatment is botulinum toxin injections but microvascular decompression surgery is another therapeutic option. we report the case of a 70 years old man with bilateral hemifacial spasms and present a brief review of the literature.
Empleo de la toxina botulínica tipo a en el tratamiento del espasmo hemifacial
Luis Chirinos,Coralis Bandres,Mary Carmen González de P,José María González
Acta Odontológica Venezolana , 2010,
Abstract: Los trastornos neuromusculares son afecciones que alteran la vida de cualquier persona, movimientos musculares incontrolados que causan molestias e interfieren en la rutina diaria. Esta revisión bibliográfica se ha llevado a cabo con la finalidad de relacionar uno de los agentes químicos más populares en la actualidad para uso estético, la Toxina Botulínica (Botox), con el tratamiento de una entidad que necesita ser tratada más allá de las banalidades de la belleza, como lo es el Espasmo Hemifacial (EHF). Son las mujeres de la 5 década de la vida quienes tienen el mayor riesgo de sufrir esta enfermedad que afecta a los músculos inervados por el nervio facial, con una incidencia de 7.4 a 14.5 casos por cada 100.000 habitantes. Estos pueden ser tratados con varias alternativas terapéuticas, pero es la Toxina Botulínica una de las más usadas, produciendo relajación en el punto exacto del músculo donde se inyecta, con el beneficio de no interferir en la trasmisión de los impulsos nerviosos, sin embargo uno de sus efectos colaterales más destacados es el botulismo, si se administra a altas dosis. Las opciones para tratar una patología pueden ser innumerables, lo importante es analizar la severidad del caso, el factor riesgo-beneficio, las condiciones sistémicas del paciente y la efectividad, duración y costo del tratamiento The neuromuscular disorders are a group of conditions that affect the nerves that control the voluntary muscles and can interfere with the activities of daily living of any given person. One of these disorders is a condition known as Hemifacial Spam (HFS) which is characterized by frequent involuntary contractions of the ipsilateral muscles innervated by the facial nerve (seventh cranial nerve). This condition more frequently affects women in the fifth decade of life and its incidence among the general population is 7.4 to 14.5 cases per 100.000 person/years. One of the most common therapeutic approaches for this condition is the use of Botulinum toxin (commonly known as Botox). This toxin works by causing the relaxation of the injected muscle reducing the abnormal contractions, though if administered in higher doses than recommended, this therapy could cause a form of botulism.: This toxin produces the paralysis of the myoneural junction causing a neuromuscular blocking effect and reducing abnormal muscle contraction. The purpose of this review is to evaluate the effects of the Botulinum toxin in the treatment of FHS, its effectiveness, side effects, duration and the risk benefits of this therapy
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