ボツリヌスA毒素治療の閉瞼筋力に及ぼす効果

Effect of botulinum toxin A on the force of eyelid closure

　本態性眼瞼痙攣21例と顔面痙攣19例に対して，ボツリヌスA毒素を眼瞼内5か所に注射した。治療効果は，閉瞼筋力とJankovic scoreで評価した。眼瞼痙攣では，注射1か月後で閉瞼筋力とJankovic scoreともに最大になり，2か月後には減弱した。顔面痙攣では，治療1か月後に効果が最大になり，治療効果が3か月間持続した。ボツリヌスA毒素の眼瞼内注射は，本態性眼瞼痙攣と顔面痙攣に有効な対症治療であると結論される。閉瞼筋力とJankovic scoreは同様の結果を示す簡便で優れた評価法であるが，より客観的な効果判定には閉瞼筋力が重要である。

We treated 21 cases of essential blepharospasm and 19 cases of hemifacial spasm by injecting botulinum type A toxin into 5 sites of the eyelids. The therapeutic effect was evaluated by using the force of eyelid closure and Jankovic score as parameters. In cases of essential blepharospasm, the effect reached its maximum one month after in-jection to gradually decrease until one month later. In cases of hemifacial spasm, the effect reached its maximum one month after injection and lasted for 3 months. The findings show that injection of botulinum toxin A is effective for es-sential and hemifacial blepharospasm. While the force of eyelid closure and Jankovic score were useful in evaluating the therapeutic effect, the former was more valuable as an objective clinical means.