Failures in Clinical Practice and a Biomechanical System for the Study of Toxin‐Induced Paralysis
作者:
John Holds,
Steven Fogg,
Richard Anderson,
期刊:
Ophthalmic Plastic and Reconstructive Surgery
(OVID Available online 1990)
卷期:
Volume 6,
issue 4
页码: 252-259
ISSN:0740-9303
年代: 1990
出版商: OVID
关键词: Botulinum A toxin;Essential blepharospasm;Neuromuscular junction;Tachyphylaxis;Rat model;Biomechanical study
数据来源: OVID
摘要:
Botulinum A toxin injection has great utility in the treatment of essential blepharospasm and other facial spasm disorders. Several investigators have noted the failure of botulinum toxin injections to relieve lid spasm in occasional patients and a decrease in effectiveness or duration of effect following multiple injections in other patients. We reviewed the charts of 30 consecutive patients presenting for the evaluation or treatment of facial dystonia. Of 20 patients who had received multiple injections of botulinum toxin, 10 patients were felt to be treatment failures. A new biomechanical system was developed to investigate the duration and degree of paralysis induced in the gastrocnemius muscle of the rat. Animals were treated with four sequential injections at 6-week intervals to the same muscle, resulting in muscle atrophy and an increase in the duration and degree of muscle paralysis, contrary to clinical findings in humans. The review of patient data confirms that, for many patients, repeated injection of botulinum toxin results in a decrease in duration and degree of effect despite an increased toxin dose. An opposite effect was noted in our experimental model because of progressive muscle atrophy.
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