Bastola P1* and Koirala S2
1Associate Professor, Consultant Ophthalmologist and Oculoplastic Surgeon, Botulinum Toxin A Expert, Kathmandu, Nepal
2Head of Department, Department of Neurology, DM Neurologist, National Academy of Medical Sciences, Kathmandu, Nepal
*Corresponding Author: Bastola P, Associate Professor, Consultant Ophthalmologist and Oculoplastic Surgeon, Botulinum Toxin A Expert, Kathmandu, Nepal.
Received: June 12, 2020; Published: July 10, 2020
Aim/Objective: The study aimed to find out the correct dosing of BTX A in treating cases of MS, ES and HS using Jankovic Spasm grading pre-treatment and orbicularis oculi muscle weakness and functional impairment improvement post treatment.
Methods: This was a hospital based, interventional, prospective study. All diagnosed consecutive patients of HS, ES and MS attending the neuro-Ophthalmologic/oculoplastic clinic, general outpatient department of Ophthalmology and or referred diagnosed cases were enrolled for the study, an informed consent was taken from all the patients before the treatment for medico-legal issues. The pre-treatment dosing was done using Jankovic spasm grading, post treatment assessment was done using orbicularis oculi muscle assessment and functional improvement. The study subjects were followed up to 9 months or till spasms reappeared.
Results: A total of 50 study subjects were enrolled in the study, 80% of them were women. The highest number of study subjects were in ES (50%) group followed by HS (40%) and MS (10%). Mean Jankovic spasm grading in all study subjects was 3.59 (± 0.38 Std. deviation). The study groups ES and MS required a higher dose of BTX A (P value: < 0.0001) when compared with HS study group. Mean orbicularis oculi muscle weakening and functional impairment improvement scale in all study subjects was 2.7 (± 0.3 Std. deviation) and 3.8 (± 0.6) respectively. Mean duration of action till the spasms reappeared in the study subjects was 5.1 months (± 1.7 Std. deviation). HS and ES study groups had better treatment when compared to MS.
Conclusions: Jankovic spasm grading pre-treatment and orbicularis oculi muscle weakness grading and functional improvement score post treatment plays a very effective role to titrate the correct dose of BTX A in patients of HS, ES and MS.
Keywords: Botulinum Toxin A; Essential Blepharospasm; Hemifacial Spasm; Jankovic Spasm Grading; Meige’s Syndrome
Citation: Bastola P and Koirala S. “The Role of Jankovic Spasm Grading, Orbicularis Oculi Muscle Function and Functional Improvement Scale Pre-and Post-Treatment in Dosing Botulinum Toxin A in Treatment of Essential Blepharospasm, Meige’s Syndrome and Hemifacial Spasm". Acta Scientific Paediatrics 3.8 (2020): 06-12.
Copyright: © 2020 Bastola P and Koirala S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.