Comparative Study On Clinical Efficacy And Influence On Psychological Status Of Local Injection With Botulinum Toxin Type A In Treating Hemifacial Spasm And Meige Syndrome

Objective: To compare the relieved degree of spasm symptoms,drug duration and the effect on psychological status when applied in patients with hemifacial spasm(HFS)or Meige syndrome(MS)by multifocal facial injection,and compare the effects of two types of botulinum toxin A,HengLi and Botox.Methods: 46 cases of HFS and 41 cases of Meige syndrome were randomly divided into two groups respectively,HengLi group(24 cases,21cases)and Botox group(22 cases,20cases),then they were injected with different types of botulinum toxin A(0.1-0.2ml per site,including botulinum toxin 5-10u)on facial spasm sites.Then,evaluating their curative efficacy according to Chorn spasm intensity grading,testing drug duration,and determing the effect on psychological status using the SCL-90 one month and three month after injection.Results: Patients with HFS and MS treated by botulinum were characterized by a strong gender bias with female dominance(78.3%,78.0%),older average age(56.98±8.56 years old,54.39±9.13 years old),longer course of disease(52.52±27.66 years old,51.76±30.42 years old),and higher degree of spasm,level III or IV(100%,100%).There was no significant difference in the efficacy of botulinum between HFS and MS 1 month after treatment(100%,100%),but obvious difference 3 months after treatment(100%,65.9%).Moreover,the drug duration median of botulinum in HFS patients was 24 weeks(16,27),longer than that in patients with MS,16 weeks(12,24),suggesting that the efficacy of botulinum in patients with HFS was better than that in patients with MS.For HFS,the effective rates of HengLi and Botox were as follows: 1 month after injection(100%,100%);3 months after injection(100%,100%).The drug duration median of two drugs was 24 weeks(16,28)and 24 weeks(16,26).There was no significant difference on efficacy between them when applied in HFS.For MS,the effective rates of HengLi and Botox were as follows: 1 month after injection(100%,100%);3 months after injection(66.7%,65%).The drug duration median was 16 weeks(12,24)and 16 weeks(12,20),respectively.There was also no significant difference on efficacy between them when applied in MS.Abnormal psychological status has been determined in patients with HFS and MS using the SCL-90 scale,and the changes observed in HFS and MS are similar.The symptoms were prominent in three psychological states: anxiety,hostility and terror.1 month after injection,the score reduction rates of two kinds of patients were both greater than the criteria of 0.25,suggesting the effect of botulinum on improving psychological status.However,there was no difference between HengLi and Botox.Conclusion: Local injection of HengLi and Botox both can relieve facial spasm and improve abnormal psychological status effectively.There is no difference between HengLi and Botox on effective rate,drug duration and the effect on psychological status,but effective rate and drug duration of two types of botulinum in primary were greater than MS.