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目的探讨长期重复应用A型肉毒毒素治疗面肌痉挛(Hemi facial spasm,HFS)对面神经电生理功能的影响。方法将44例HFS患者分别依据病程及接受肉毒毒素治疗的次数分为3组早期组(16例)、长期未治疗组(10例)、长期重复治疗组(18例),并测量患者双侧面神经传导速度及复合肌肉动作电位波幅。结果长期重复治疗组面神经诱发肌电图的CMAP波幅患侧较健侧显著降低,其余2组CMAP(Compound muscle action potential)波幅及3组患者潜速率患健侧自身对比均无显著性差异。结论长期A型肉毒毒素局部注射治疗HFS安全、疗效显著,且降低治疗侧的CMAP波幅对面神经传导速度无明显影响。
Objective To investigate the effect of long-term repeated application of botulinum toxin type A on the electrophysiological function of facial nerve in treating hemifacial spasm (HFS). Methods Forty-four patients with HFS were divided into three groups according to their course of disease and the number of botulinum toxin treatment: early group (16 cases), long-term untreated group (10 cases) and long-term repeated treatment group (18 cases) Lateral nerve conduction velocity and compound muscle action potential amplitude. Results Compared with the contralateral side, the amplitude of CMAP induced by facial nerve-evoked EMG in long-term repeated treatment group was significantly lower than that in non-contralateral side. There was no significant difference between the amplitude of compound muscle action potential (CMAP) in other two groups and the contralateral rate of contralateral velocity in the three groups. Conclusion Long-term local injection of botulinum toxin type A is safe and effective in treating HFS, and reducing CMAP amplitude on the treatment side has no significant effect on facial nerve conduction velocity.