Navegando por Palavras-chave "Espasmo hemifacial"

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    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.
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    Alterações na topografia e tomografia corneal e na morfometria palpebral em pacientes com espasmo hemifacial tratados com toxina botulínica-A
    (Universidade Federal de São Paulo (UNIFESP), 2016-03-30) Osaki, Teissy Hentona [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; http://lattes.cnpq.br/8668472375424523; http://lattes.cnpq.br/2445560965373609; Universidade Federal de São Paulo (UNIFESP)
    Purposes: 1) to evaluate possible corneal topographic and tomographic changes, in addition to eyelid morphometric changes in affected and normal contralateral eyes of patients with hemifacial spasm (HFS) treated with botulinum-A toxin (BTX-A); 2) to evaluate possible eyelid morphometric changes in affected and normal contralateral eyes of patients with HFS treated with BTX-A; 3) to compare two types of corneal imaging systems (Placido system versus Scheimpflug system) to evaluate corneal topographic parameters in patients with hemifacial spasm. Methods: Changes in corneal topographic and tomographic (magnitude of corneal astigmatism and steepest keratometry) and eyelid morphometric (palpebral fissure and interpalpebral surface area) parameters were evaluated in patients with hemifacial spasm during a complete treatment cycle (before, 15 days, two, three and four months) after BTX-A (Botox®, Allergan, Irvine, EUA) applications in the affected hemiface. For eyelid morphometric analysis, we used the Image J software. For corneal topographic analysis, Placido system (ATLAS; Carl Zeiss Meditec, Dublin, CA) was used, and for corneal tomographic evaluation, we used the Scheimpflug system (Pentacam Oculus, Inc., Berlin, Germany). Results: Twenty-four HFS patients were treated with BTX-A. On the normal hemiface, before treatment, palpebral fissure (PF), interpalpebral surface area (ISA), steepest K and corneal astigmatism (Placido system/ Scheimpflug system) measurements were: 8,7 ± 1,98 mm, 122,09 ± 39,37 mm2, 44,99± 1,45/ 44.89±1.33 D and 0,9 ± 0,64 D/ 0.87±0.87 D, respectively. No significant changes were observed in eyelid and corneal parameters over the four months on the normal hemiface. On the affected hemiface, before treatment, palpebral fissure (PF), interpalpebral surface area (ISA), steepest K and corneal astigmatism (Placido system/ Scheimpflug system) measurements were: 5,5 ± 1,77 mm, 67,68 ± 28,49 mm2, 46,91 ± 3,57 D/ 45.40±1.37 D, 2,63 ± 2.46D/ 1,27 ± 0,88 D, respectively. There was a significant increase in PF and ISA (8,36 ± 1,91 mm and 115,92 ± 34,44 mm2, respectively at 15 days; 8,18 ± 1,80 mm and 112,22 ± 33,57 mm2, respectively at 2 months, and 7,27 ± 1,65 mm and 95,48 ± 27,80 mm2, respectively at 3 months), and a significant reduction in steep K and corneal astigmatism (45,14 ± 1,20 D and 1,01 ± 0,58 D, respectively at 2 months, and 45,64 ± 1,77 D and 1,36 ± 1,31D, respectively at 3 months), when evaluated by Placido system, on the affected hemiface. Scheimpflug system did not detect changes in the steepest keratometric reading over the four months. This system detected significant reductions in corneal astigmatism values only at 15 days (1,16 ± 1.16D; p = 0,02) and at 4 months (0,91 ± 0,59; p = 0,03). Both the lid morphometric and the topographic corneal parameters tended to return to baseline values four months after application of BTX-A. Comparison between corneal topographic parameters, obtained with Placido system, between both affected and normal eyes showed statistically significant differences between both eyes before and four months after treatment. Steep K (46.91± 3.57 D) and astigmatism values (2.63± 2.46 D) were significantly higher in affected eyes of HFS patients than in non-affected eyes (44.99±1.45 D and 0.90±0.64 D) before treatment (p=0.001 for steep K and p=0.0003 for astigmatism). Astigmatism values were also were significantly higher in affected eyes (1.42±0.83D) than in non-affectted eyes (0.91±0.64D) at four months (p=0.006). Differences between both eyes tended to reduce during the BTX-A period of action. Conclusions: 1) Treatment with BTX-A in patients with HFS led to temporary corneal topographic changes on the affected eye during BTX-A period of action. Corneal tomographic parameters did not show a so discernible pattern reflecting BTX-A period of action; 2) Treatment with BTX-A in patients with HFS also led to temporary eyelid morphometric changes on the affected eye during BTX-A period of action; 3) Corneal changes on the affected side were best detected with Placido system than with Scheimpflug system.
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    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.
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    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.