ボツリヌス毒素療法の成績

Outcome of treatments with botulinum toxin

要約　過去5年間に412症例に対してボツリヌス毒素療法を行った。内訳は眼瞼痙攣172例と片側顔面痙攣240例で，男性122例，女性290例である。平均年齢は66±11歳，平均投与回数は7.4±5.7回であり，平均観察期間は2.0±1.6年である。投与のたびにアンケート調査を行い，81％の症例が治療に満足していた。効果持続期間は，眼瞼痙攣が2.4か月，片側顔面痙攣が3.5か月で，後者が有意に長かった（p＜0.00000001）。治療の中断は，眼瞼痙攣では効果不十分，片側顔面痙攣では治療が奏効したことがその主な理由であった。23例で抗体検査を実施し，その全例で陰性であった。ボツリヌス毒素療法は，満足度が高く，全身的な副作用も皆無であった。発症初期に治療をすれば治癒の可能性が高くなると考えられるため，早期治療が望ましい。

Abstract.　We reviewed 412 patients treated with botulinum toxin type A during the past 5 years. The series comprised blepharospasm 172 cases and hemifacial spasm 240 cases. There were 122 males and 290 females. Their ages averaged 66±11 years. Treatment was repeated at an average of 7.4±5.7 sessions. Cases were followed up for 2.0±1.6 years. When asked at each session,81％ of patients expressed their satisfaction over the outcome. The effect of treatment lasted for 2.4 months in blepharospasm and 3.5 months in hemifacial spasm. The difference was significant（p＜0.00000001）. Treatment was discontinued in some patients due to insufficient effect for blepharospasm and to apparent cure for hemifacial spasm. Antibodies for botulinum toxin were negative in all the 23 tested cases. The findings show that this therapeutic modality is generally effective and is free of complications. Early treatment appears to be essential to achieve a higher rate of cure.