【摘要】 目的探讨面肌痉挛的病因，评估Ａ型肉毒毒素治疗面肌痉挛的疗效。方法对１１８例病人进行面部肌肉多点注射Ａ型肉毒毒素治疗，对治疗前后的病情分级进行对比，并随机抽取３６例做肌电图，１２例做核磁共振血管成像（ＭＲＡ）检查。结果Ａ型肉毒毒素有效率为９４％，半年复发率为８７％。肌电图全部显示自发性动作电位。１２例ＭＲＡ中，１１例检出有椎动脉、小脑后下动脉、小脑前下动脉的变异，并造成对面神经的压迫。结论部分面肌痉挛的病因为血管压迫。尽管Ａ型肉毒毒素的疗效多不超过半年，但仍不失为一种简单有效的治疗方法更多还原

【Abstract】 Objective To explore the cause of hemifacial spasm (HFS) and evaluate the therapeutic efficacy of botulin A. Methods 118 HFS patients were studied on therapeutic efficacy of multifocal facial injections with botulin A. Symptomatic alleviations after the injection were graded in comparison with the symptoms at the pretreatment stage. Electromyography (EMG) was performed in 36 patients and magnetic resonance angiography (MRA) in 12 patients at random. Results Following the treatment, 94% of the patients were relieved of symptoms, but 87% of the patients relapsed about half a year later. EMG was performed in 36 patients with the presence of spontaneous action potentials. MRA was performed in 12 patients, demonstrating the aberrances of the vertebral artery, the posterior inferior cerebellar artery or the anterior inferior cerebellar artery, with certain compressions of the involved facial nerves in 11 cases. Conclusions The vascular compression of the involved facial nerves might be identified as the more likely cause of HFS. Therapeutic efficacy of botulin A usually lasted no longer than six months. Substantially, the botulin A injections could serve as a kind of easy and useful symptomatic treatment.更多还原