No clinical or neurophysiological evidence of botulinum toxin diffusion to non-injected muscles in patients with hemifacial spasm
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Botulinum toxin injected into a muscle may diffuse to nearby muscles thus producing unwanted effects. In patients with hemifacial spasm, we evaluated clinically and neurophysiologically, whether botulinum toxin type A (BoNT-A) diffuses from the injection site (orbicularis oculi) to untreated muscles (orbicularis oris, the affected side; and orbicularis oculi and oris; the unaffected side). We studied 38 patients with idiopathic hemifacial spasm. Botulinum toxin was injected into the affected orbicularis oculi muscle alone (at 3 standardized sites) at a clinically effective dose.
Patients were studied before (T0) and 3-4 weeks after treatment (T1). We evaluated the clinical effects of botulinum toxin and muscle strength in the affected and unaffected muscles. We also assessed the peak-to-peak amplitude compound muscle action potential (CMAP) recorded from the orbicularis oculi and orbicularis oris muscles on both sides after supramaximal electrical stimulation of the facial nerve at the stylomastoid foramen.
In all patients, botulinum toxin treatment reduced muscle spasms in the injected orbicularis oculi muscle and induced no muscle weakness in the other facial muscles. The CMAP amplitude significantly decreased in the injected orbicularis oculi muscle, but remained unchanged in the other facial muscles (orbicularis oris muscle on the affected side and contra-lateral unaffected muscles). In conclusion, in patients with hemifacial spasm, botulinum toxin, at a clinically effective dose, induces no clinical signs of diffusion and does not reduce the CMAP size in the nearby untreated orbicularis oris or contralateral facial muscles.
- Berardelli A, A Formica, B Mercuriet al. (1993) Botulinum toxin treatment in patients with focal dystonia and hemifacial spasm. A multicenter study of the Italian Movement Disorders Study Group.Ital. J. Neurol. Sci. 14, 361–368. CrossRef
- Berardelli A, F Gilio and A Currà (2002) Effects of botulinum toxin type A on central system function, In:Scientific and Therapeutic Aspects of Botulinum Toxin (Brin MF, K Jankovic and M Hallett, Eds.) (Lippincott Williams & Wilkins: Philadelphia, PA), pp 171–177.
- Borodic GE, R Ferrante, LB Pearce and K Smith (1994) Histological assessment of dose-related diffusion and muscle fiber response after therapeutic botulinum A toxin injections.Mov. Disord. 9, 31–39. CrossRef
- Brin MF, KE Lyons, J Doucette CH Adler, JN Caviness, CL Comella, RM Dubinsky, JH Friedman, BV Manyam, JY Matsumoto, SL Pullman, AH Rajput, KD Sethi, C Tanner and WC Koller (2001) A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor.Neurology 56, 1523–1528.
- Cohen LG, M Hallett, BD Geller and F Hochberg (1989) Treatment of focal dystonias of the hand with the botulinum toxin injections.J. Neurol. Neurosurg. Psychiatry 52, 355–363. CrossRef
- Costa J, C Esperito-Santo, A Borges, JJ Ferreira, M Colheo, P Moore and C Sampaio (2005) Botulinum toxin type A therapy for hemifacial spasm.Cochrane Database Syst. Rev. 25, CD004900. Review.
- Currà A, C Trompetto, G Abruzzese and A Berardelli (2004) Central effects of botulinum toxin type A: evidence and supposition.Mov. Disord. 19, 60–64. CrossRef
- Defazio G, G Abbruzzese, P Girlanda L Vacca, A Curra, R De Salvia, R Marchese, R Raineri, F Roselli, P Livrea and A Berardelli (2002) Botulinum toxin A treatment for primary hemifacial spasm: a 10-year multicenter study.Arch. Neurol. 59, 418–420. CrossRef
- Eleopra R, V Tugnoli, L Caniatti and D Degrandis (1996) Botulinum toxin treatment in the facial muscles of humans: evidence of an action in untreated near muscle by peripheral local diffusion.Neurology 46, 1158–1160.
- Garner CG, A Straube, TN Witt, T Gasser and WH Oertel (1993) Time course of distant effects of local injections of botulinum toxin.Mov. Disord. 8, 33–37. CrossRef
- Hallett M (2002) Effects of Botulinum toxin at the neuromuscolar junction, In:Scientific and Therapeutic Aspects of Botulinum Toxin (Brin MF, J Jankovic and M Hallett, Eds.) (Lippincott Williams & Wilkins: Philadelphia, PA), pp 167–170.
- Jankovic J, K Schwartz, W Clemence, A Aswad and J Mordaunt (1996) A randomised, double-blind, placebo-controlled study to evaluate botulinum toxin type A in essential hand tremor.Mov. Disord. 11, 250–256. CrossRef
- Lange DJ, M Rubin, PE Greeneet al. (1991) Distant effects of locally injected botulinum toxin: a double-blind study of single fiber EMG changes.Muscle Nerve 41, 672–675. CrossRef
- Naumann M and J Jankovic (2004) Safety of botulinum toxin type A: a systematic review and metanalysis.Curr. Med. Res. Opin. 20, 981–990 CrossRef
- Shaari CM, E George, BL Wu, HF Biller and I Sanders (1991) Quantifying the spread of botulinum toxin through muscle fascia.Laryngoscope 101, 960–964. CrossRef
- Wang A and J Jankovic (1998) Hemifacial spasm: clinical correlates and treatments.Muscle Nerve 21, 1740–1747. CrossRef
- No clinical or neurophysiological evidence of botulinum toxin diffusion to non-injected muscles in patients with hemifacial spasm
Volume 9, Issue 2-3 , pp 141-144
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