ボツリヌス毒素製剤による眼瞼痙攣治療成績

The effect of botulinum toxin type A on blepharospasm

　A型ボツリヌス毒素治療を眼瞼痙攣患者43名に行った。本態性眼瞼痙攣33例，Meige症候群10例のうち男性11名，女性32名であり，平均年齢は65.5±10.6歳であった。眼輪筋への注射は，眼瞼部5か所と下眼窩部1か所に行った。著明な改善が36例（84％）に得られ，再投与が必要になるまでの期間は平均6.8±3.3か月であった。格別の副作用はなかった。効果持続期間が既報よりも長かったのは，患者の環境と地域性によると考えた。以上の結果から，眼瞼痙攣にはボツリヌス毒素による治療が有効かつ安全であり，特に高齢者に対しては外科的治療よりも優先すると結論される。

We treated 43 patients of blepharospasm using botulinum toxin type A. The series comprised 33 cases of essential blepharospasm and 10 cases of Meige syndrome. There were 11 males and 32 females. Their ages averaged 65.5±10.6 years. Botulinum toxin was injected into 5 sites of orbicularis oculi in the eyelid and 1 site of its infraorbital portion. Remarkable improvement resulted in 36 cases (84%). Additional treatment became necessary after an ave-rage of 6.8±3.3 months. There was no complication throughout. The duration of improvement was longer that previ-ously reported, probably due to social and geographical peculiarities in the present series. These findings show that treatment of blepharospasm by botulinum toxin is safe and effective and that this therapeutic modality is to be pre-ferred to surgery particularly in senile patients.