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Experiência com aplicação de toxina botulínica A em 115 pacientes

Botulinum toxin A: experience in the treatment of 115 patients

Resumos

A toxina botulínica A é a forma mais eficaz de tratar algumas distonias focais e o espasmo hemifacial. Devido a seu custo ainda elevado no nosso país, seu uso ainda não é disseminado. Mostramos nossa experiência com a toxina botulínica A em 115 pacientes, sendo 45 com espasmo hemifacial que apresentaram melhora acentuada ou total em 100%. Em 20 pacientes com blefaroespasmo essencial houve melhora acentuada ou total em 70% . Na síndrome de Meige, representada por 14 pacientes, a melhora acentuada ou total foi observada em 71,4%. Em 23 pacientes com distonia cervical observou-se melhora acentuada em 65,2%. Distonia da mão, com 6 pacientes, apresentou o menor índice de melhora acentuada (2 pacientes, 33,3%). As complicações de caráter transitório ocorreram, sendo as mais frequentes ptose palpebral e diminuição da força palpebral e a mais grave, pneumonia aspirativa. Acreditamos que a toxina é forma eficaz e habitualmente segura de tratamento destas condições clínicas.

toxina botulínica A; Botox; distonias focais; espasmo hemifacial


Botulinum toxin A is the more efficient therapy of focal dystonias and hemifacial spasm. Our experience with botulinum toxin A injections in 115 patients is reported. Marked or total improvement was achieved in all 45 patients with hemifacial spasm, in 70% of 20 patients with essential blepharospasm and in 71.4% of 14 patients with Meige's syndrome. In 65.2% of 23 patients with cervical dystonia marked but no total improvement was obtained. The worse results were seen in the 6 patients with hand dystonia (writers cramp), in whom marked improvement was obtained in just two. Mild and transient complications occurred in up to 24.4%, eyelid ptosis and eyelid weakness being the most frequent. One patient with Meige's syndrome had an aspiration pneumonia following dysphagia. Our results are in agreement with others, showing that botulinun toxin A is a useful and safe treatment for these conditions.

botulinun toxin A; Botox; focal dystonias; hemifacial spasm


Experiência com aplicação de toxina botulínica A em 115 pacientes

Botulinum toxin A: experience in the treatment of 115 patients

Luiz Augusto F. AndradeI; Vanderci BorgesII; Henrique Ballalai FerrazIII; Sonia Maria Azevedo-SilvaII

ISetor de Distúrbios do Movimento da Disciplina de Neurologia Clínica do Departamento de Neurologia e Neurocirurgia da Universidade Federal de São Paulo - Escola Paulista de Medicina. São Pauilo: Professor Livre Docente, Chefe da Disciplina de Neurologia Clínica

IISetor de Distúrbios do Movimento da Disciplina de Neurologia Clínica do Departamento de Neurologia e Neurocirurgia da Universidade Federal de São Paulo - Escola Paulista de Medicina. São Pauilo: Mestre em Neurologia

IIISetor de Distúrbios do Movimento da Disciplina de Neurologia Clínica do Departamento de Neurologia e Neurocirurgia da Universidade Federal de São Paulo - Escola Paulista de Medicina. São Pauilo: Doutor em Neurologia, Professor da Pós-Graduação

RESUMO

A toxina botulínica A é a forma mais eficaz de tratar algumas distonias focais e o espasmo hemifacial. Devido a seu custo ainda elevado no nosso país, seu uso ainda não é disseminado. Mostramos nossa experiência com a toxina botulínica A em 115 pacientes, sendo 45 com espasmo hemifacial que apresentaram melhora acentuada ou total em 100%. Em 20 pacientes com blefaroespasmo essencial houve melhora acentuada ou total em 70% . Na síndrome de Meige, representada por 14 pacientes, a melhora acentuada ou total foi observada em 71,4%. Em 23 pacientes com distonia cervical observou-se melhora acentuada em 65,2%. Distonia da mão, com 6 pacientes, apresentou o menor índice de melhora acentuada (2 pacientes, 33,3%). As complicações de caráter transitório ocorreram, sendo as mais frequentes ptose palpebral e diminuição da força palpebral e a mais grave, pneumonia aspirativa. Acreditamos que a toxina é forma eficaz e habitualmente segura de tratamento destas condições clínicas.

Palavras-chave: toxina botulínica A, Botox, distonias focais, espasmo hemifacial.

ABSTRACT

Botulinum toxin A is the more efficient therapy of focal dystonias and hemifacial spasm. Our experience with botulinum toxin A injections in 115 patients is reported. Marked or total improvement was achieved in all 45 patients with hemifacial spasm, in 70% of 20 patients with essential blepharospasm and in 71.4% of 14 patients with Meige's syndrome. In 65.2% of 23 patients with cervical dystonia marked but no total improvement was obtained. The worse results were seen in the 6 patients with hand dystonia (writers cramp), in whom marked improvement was obtained in just two. Mild and transient complications occurred in up to 24.4%, eyelid ptosis and eyelid weakness being the most frequent. One patient with Meige's syndrome had an aspiration pneumonia following dysphagia. Our results are in agreement with others, showing that botulinun toxin A is a useful and safe treatment for these conditions.

Key-words: botulinun toxin A, Botox, focal dystonias, hemifacial spasm.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 29-abril-1997.

Dr. Luiz Augusto Franco de Andrade - Rua Borges Lagoa 1231, conj.44 - 04038-033 São Paulo SP - Brasil.

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Datas de Publicação

  • Publicação nesta coleção
    18 Out 2010
  • Data do Fascículo
    Set 1997
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