Navegando por Palavras-chave "Blepharospasm"
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- ItemAcesso aberto (Open Access)Aberrações ópticas de alta ordem em pacientes com distonias faciais tratados com toxina botulínica(Conselho Brasileiro de Oftalmologia, 2011-12-01) Yabiku, Mariann Midori [UNIFESP]; Sartori, Juliana De Filippi [UNIFESP]; Sarraff, Eduardo Pantaleão [UNIFESP]; Osaki, Tammy Hentona [UNIFESP]; Hossaka, Sidarta Keizo [UNIFESP]; Pereira, Carolina Isolane [UNIFESP]; Freitas, Wilson De [UNIFESP]; Osaki, Midori Hentona [UNIFESP]; Cariello, Angelino Julio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze the ocular wavefront aberrations in patients with facial dystonia treated with botulinum toxin A. METHODS: Patients with benign essential blepharospasm and hemifacial spasm in activity underwent slit lamp examination and bilateral wavefront analysis under pharmacologic mydriasis using Alcon LADARvision® wavefront aberrometry system. After that, all patients were treated with botulinum toxin A injections performed by the same ophthalmologist. After one month, the wavefront analysis was performed in the same way and by the same examiner. The main outcome measure was the change in ocular wavefront aberrations. Paired T-test was used to compare pre and post-injection numeric wavefront values. RESULTS: From a total of 11 patients enrolled in this study, 6 (54.5%) had essential blepharospasm and 5 (45.5%) had hemifacial spasm. The fellow eyes of patients with hemifacial spasm were not included, totalizing 17 eyes with spasm. Eight patients were female (72.7%) and three were male (27.3%), the male:female ratio was 1:2.6. The age ranged from 50 to 72 years old with a mean of 65.9 ± 8.2 years. The mean of high order root mean square (RMS) wavefront aberrations was 0.68 before and 0.63 one month after the treatment (p=0.01). Before the treatment, the mean of spherical aberration was 0.23 and decreased to 0.17 one month after the treatment (p=0.01). There was no significant difference in the other higher-order aberrations before and after the treatment (p>0.05). CONCLUSION: The treatment with botulium toxin may decrease spherical aberrations in patients with facial dystonia.
- ItemAcesso aberto (Open Access)Estudo dos distúrbios do sono em pacientes com distonia focal: blefaroespasmo(Universidade Federal de São Paulo (UNIFESP), 2020-07-30) Lestingi, Silvia Cordova [UNIFESP]; Borges, Vanderci [UNIFESP]; Coelho, Fernando Morgadinho Santos [UNIFESP]; http://lattes.cnpq.br/4520146294812879; http://lattes.cnpq.br/2742450111759824; http://lattes.cnpq.br/5531342388610304; Universidade Federal de São PauloObjective: We evaluated the quality of sleep and circadian rhythm in a sample of Brazilian blepharospasm patients. Methods: A total of 51 patients, who met the clinical criteria for blepharospasm, evaluated by two specialists in movement disorders, were recruited from the outpatient clinic for movement disorders of two reference centers in the city of São Paulo: Federal University of São Paulo and São Paulo Public Servants Hospital. The selected 13 patients were evaluated from 13 days before to 13 days after the use of botulinum toxin. They were interviewed, underwent physical examination and actigraphy, and completed sleep diaries. Results: Seven patients (58.8%) were at risk for developing obstructive sleep apnea syndrome (OSAS). The quality of sleep was poor for eight patients (61.5%) and showed a strong positive correlation coefficient with insomnia. After the use of botulinum toxin, the group that reported sleep improvement exhibited a 50% decrease in sleep latency. There was no change in the circadian rhythm. Patients who reported no sleep improvement after the use of botulinum toxin presented with poorer synchronization of the light-dark cycle. Conclusion: Blepharospasm patients present with poor sleep quality, displaying a strongly positive correlation with the insomnia severity index. About 50% of the patients presented with sleep improvement after using botulinum toxin. The synchronization of the light-dark cycle may influence this improvement.
- ItemAcesso aberto (Open Access)Influência da toxina botulínica tipo A na função lacrimal de pacientes com distonias faciais(Conselho Brasileiro de Oftalmologia, 2010-10-01) Oliveira, Fernanda Castro de [UNIFESP]; Oliveira, Gustavo Castro de; Cariello, Angelino Julio [UNIFESP]; Felberg, Sergio; Osaki, Midori Hentona [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze the influence of botulinum toxin on the lacrimal function of patients with facial dystonias. METHODS: Patients with the diagnosis of hemifacial spasm or benign essential blepharospasm were evaluated and invited to answer the Ocular Surface Index Disease (OSID) questionnaire. All patients underwent Schirmer I and basal tests; break-up time (BUT) test and lacrimal clearance evaluation. On the following day, the patients were treated with botulinum toxin. The Ocular Surface Index Disease questionnaire and all the initial tests were reapplied 30 days after the treatment by the same examiner. RESULTS: Twenty-six patients were enrolled in this study, 15 (57.7%) with hemifacial spasm and 11 (42.3%) with benign essential blepharospasm. The mean age of patients with hemifacial spasm was 70.9 ± 13.3 years and the male:female ratio was 1:1.5. In the group of patients with benign essential blepharospasm, the mean age was 68.9 ± 8.4 years with a female preponderance (90.0%). After the treatment, the Ocular Surface Index Disease score, Schirmer I and basal tests score decreased in both groups. The mean of Break-up time test increased significantly in both groups. The lacrimal clearance evaluation showed a greater number of eyes that achieved a complete drainage of the tears after the treatment in both groups. CONCLUSION: The treatment with botulinum toxin improved dry eye symptoms in patients with facial dystonia. Despite of the aqueous portion of tear have decreased, blink modifications improved the tear stability and drainage.
- ItemAcesso aberto (Open Access)Qualidade de vida e custos diretos em pacientes com blefaroespasmo essencial e espasmo hemifacial, tratados com toxina botulínica-A(Conselho Brasileiro de Oftalmologia, 2004-02-01) Osaki, Midori Hentona [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To evaluate both the costs and the impact on the quality of life of essential blepharospasm and hemifacial spasm patients treated with botulinum toxin-A. METHODS: 28 patients (16 essential blepharospasm and 12 hemifacial spasm), treated with BTX-A, were evaluated by means of two research tools, namely Medical Outcomes Study Short Form Healthy Survey, and Fahn Disability Rating Scale. The costs were mainly calculated on the basis of the toxin units used by each patient during a one-year period. RESULTS: The total estimated direct cost was estimated at 1,081.62 reais per year (±89.39) for essential blepharospasm and 618.06 reais per year (±60.06) for hemifacial spasm, at an outpatient level (p<0.001). Before treatment all domains of SF-36 were significantly worse in both diseases. Under effective treatment with botulinum toxin-A the increases in the indices of SF-36 show changes in the general health rates of the population under study, with a statistically significant difference between the pre and post answers (p<0.05). In relating SF-36 with the Fahn Disability Rating Scale, the essential blepharospasm cases showed significant positive relationships (functional capacity, general health, emotional aspect and social aspects) while in the hemifacial spasm patients no correlation was found. CONCLUSION: The present study demonstrates a remarkable negative impact of both diseases on the quality of life of essential blepharospasm and hemifacial spasm patients, as well as a significant improvement of both diseases after botulinum toxin-A treatment. Furthermore, the research data seem to justify the high costs of botulinum toxin-A treatment in view of its considerable benefits regarding the patients' quality of life.