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目的探讨 A 型肉毒毒素治疗咀嚼肌痉挛患者的疗效。方法 16例咀嚼肌痉挛患者,男女患者各8例,年龄21～87岁,平均61.7岁,其中表现为单纯咬颌型(Ⅰ型)的咀嚼肌痉挛12例,下颌错动型(Ⅱ型)4例,所有患者临床表现均为发作性咬牙、张口困难,神经系统无其他阳性体征,头颅 CT 或 MRI 无异常发现。咬颌型主要累及咬肌和颞肌,而错动型同时累及翼肌。应用 A 型肉毒毒素对患侧咀嚼肌采用多点注射方法,观察其治疗效果和副作用。结果 13例症状得到显著改善(4例单侧咬颌型,8例双侧咬颌型中7例,4例下颌错动型中2例),3～10 d 起效,疗效持续时间8～26周,4例注射后出现患侧咬肌轻度麻痹,数周内恢复,未见其他副作用。症状复发者再次注射仍然有效。结论咀嚼肌痉挛患者局部注射 A 型肉毒毒素,确为一种有效、安全、简便易行的治疗手段,能在一段时间内缓解甚至消除肌肉痉挛及相关症状。
Objective To investigate the efficacy of botulinum toxin type A in the treatment of patients with masticatory muscle spasm. Methods Twenty - six patients with masticatory muscle spasm, 8 males and 8 females, aged from 21 to 87 years, averaged 61.7 years old, including 12 cases of masticatorial spasm with simple bite - In 4 cases, all patients had seizures, severe mouth opening, no other positive signs in the nervous system, no abnormal CT or MRI findings. Bite jaw type mainly involving the masseter and temporal muscles, while the wrong type also affects the wing muscle. Botulinum toxin type A was applied to the affected side of the masticatory muscle by multi-point injection to observe its therapeutic effect and side effects. Results The symptoms were significantly improved in 13 cases (4 cases of unilateral bite - type jaw, 8 cases of bilateral bite - jaw type in 2 cases, 4 cases of mandibular malposition type in 2 cases), 3 ~ 10 d onset, duration of effect 8 ~ After 26 weeks, mild side paralysis of the affected side masseter occurred after 4 cases of injection and recovered within several weeks with no other side effects. Recurrence of symptoms of re-injection is still valid. Conclusions Local injection of botulinum toxin type A in patients with masticatory muscle spasm is indeed an effective, safe and simple treatment that can relieve or even eliminate muscle spasms and related symptoms in a period of time.