Langzeitbeobachtungen zur Injektionsdynamik der Botulinum-Toxin-Therapie bei Patienten mit verschiedenen fazialen Dyskinesien

Long term observations in the dynamic of botulinum toxin treatment in patients with facial movement disorders

by Anna Maria Niemczewska-Dreher
Doctoral thesis
Date of Examination:2013-11-25
Date of issue:2013-10-30
Advisor:Prof. Dr. Rainer Laskawi
Referee:Prof. Dr. Rainer Laskawi
Referee:Prof. Dr. David Liebetanz
Persistent Address: http://dx.doi.org/10.53846/goediss-4123

 

 

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Abstract

English

Abstract Background: Rare information exists about the long term development of patients with blepharospasm, hemifacial spasm and synkinesis following defective healing of the facial nerve. This retrospective analysis deals with the course of different parameters of injection over the time. Methods: In this study we analysed the development of long-term botulinum toxin treatments of patients with blepharospasm, hemifacial spasm and synkinesis. 80 patients (female 59, male 21, mean age 68 years, range 41-93 years, n=30 blepharospasm, n=31 hemifacial spasm, n=19 synkinesis) of the clinic for head and neck movement disorders, department of ENT of the Georg- August-University Goettingen, Germany, who had at least 10 consultations for BTA-injections, were included in the retrospective study. The development for each entity in total dosage, increase in the number of injection points and change in dosages for each point were evaluated. Results: The over-all dosage in all three clinical pictures and for each single disease itself increased continuously over the time. The amount of injection points increased in the treatment of hemifacial spasm and synkinesis. The dosage per point increased most in blepharospasm, but was distinctly lower in patients with hemifacial spasm and synkinesis (lowst level). The increase in dosage in blepharospasm is therefore, in contrast to hemifacial spasm and synkinesis, mostly caused by an increase in dosage per point in relatively constant injection points. Conclusion: These new aspects of the dynamic in the treatment with botulinum toxin enable the physician to understand better the dynamic of these diseases, to optimize treatment protocols and to improve counseling.
Keywords: Blepharospasm; Hemifacial Spasm; Facial Synkinesis; Longterm Results; Botulinum Toxin
Schlagwörter: Blepharospasmus; Spasmus hemifacialis; Synkinesien; vergleichende Langzeitbeobachtungen; Botulinumtoxin
 
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